Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-27T21:36:42.009Z Has data issue: false hasContentIssue false
  • English
  • Français

Patterns of neuropsychological deficit in alcoholic Korsakoff's Syndrome

Published online by Cambridge University Press:  09 July 2009

R. R. Jacobson ,
C. F. Acker  and
W. A. Lishman
R. R. Jacobson*
Affiliation:
Institute of Psychiatry, London
C. F. Acker
Affiliation:
Institute of Psychiatry, London
W. A. Lishman
Affiliation:
Institute of Psychiatry, London
*
1Address for correspondence: Dr R. R. Jacobson, Si Georges's Hospital, Medical School, Department of Psychiatry, Jenner Wing, Cranmer Terrace, London SW17 ORE.
Get access Rights & Permissions [Opens in a new window]

Synopsis

Twenty-five male and 13 female patients with alcoholic Korsakoff's syndrome (AKS) were compared with age- and sex-matched non-Korsakoff chronic alcoholics and healthy volunteers in a neuropsychological study, which included computer-administered tests of cognitive function. The performance of male Korsakoff patients was significantly inferior to that of healthy male controls, not only in tests of memory, but also in visuo-perceptual tasks with a speed or motor component, and on category sorting and verbal fluency measures. Compared with male alcoholics, the performance of male Korsakoff patients was again inferior on similar tests. Female Korsakoff patients showed more extensive deficits compared with female controls, but differed less from matched female alcoholics.

The results suggest that, in addition to their amnesia, many Korsakoff patients have sustained widespread cognitive deficits, affecting particularly visuo-perceptual and abstracting functions, which are sensitive to cortical lesions. The range of deficits falls short of what may be regarded as ‘global’ in male, but probably not in female, Korsakoffs. The implications for a dual aetiology of AKS involving thiamine deficiency and other features associated with alcoholism, probably direct alcohol neurotoxicity, are discussed.

Type
Original Articles
Information
Psychological Medicine , Volume 20 , Issue 2 , May 1990 , pp. 321 - 334
Copyright
Copyright © Cambridge University Press 1990

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Acker, C. (1985). Performance of female alcoholics on neuropsychological testing. Alcohol and Alcoholism 20, 379–386.Google ScholarPubMed
Acker, C. (1986). Neuropsychological deficits in alcoholics: the relative contributions of gender and drinking history. British Journal of Addiction 81, 395–403.CrossRefGoogle ScholarPubMed
Acker, C. & Acker, C. F. (1982). Bexley-Maudsley Automated Psychological Screening and Bexley-Maudsley Category Sorting Test: Manual. NFER-Nelson: Windsor.Google Scholar
Acker, C., Acker, W. & Shaw, G. K. (1984 a). Assessment of cognitive function in alcoholics by computer: a control study. Alcohol and Alcoholism 19, 223–233.Google ScholarPubMed
Acker, W., Aps, E. J., Majumdar, S. K., Shaw, G. K. & Thomson, A. D. (1982). The relationship between brain and liver damage in chronic alcoholic patients. Journal of Neurology, Neurosurgery and Psychiatry 45, 984–987.CrossRefGoogle ScholarPubMed
Acker, W., Ron, M. A., Lishman, W. A. & Shaw, G. K. (1984 b). A multivariate analysis of psychological, clinical and CT scanning measures in detoxified chronic alcoholics. British Journal of Addiction 79, 293–301.CrossRefGoogle ScholarPubMed
Adams, K. M. & Grant, I. (1986). Influence of premorbid risk factors on neuropsychological performance in alcoholics. Journal of Clinical and Experimental Neuropsychology 8, 362–370.CrossRefGoogle ScholarPubMed
Armitage, P. & Berry, G. (1987). Statistical Methods in Medical Research. Blackwell Science Publications: Oxford.Google Scholar
Benton, A. L. (1974). Revised Visual Retention Test. The Psychological Corporation: New York.Google Scholar
Bergman, H. (1987). Brain dysfunction related to alcoholism: some results from the KARTAD project. In Neuropsychology of Alcoholism: Implications for Diagnosis and Treatment (ed. Parsons, O. A., Butters, N. & Nathan, P.), pp. 21–44. Guilford Press: New York.Google Scholar
Butters, N. (1985). Alcoholic Korsakoff's Syndrome: some unresolved issues concerning etiology, neuropathology, and cognitive deficits. Journal of Clinical and Experimental Neuropsychology 7, 181–210.CrossRefGoogle ScholarPubMed
Butters, N. & Cermak, L. S. (1980). Alcoholic Korsakoff's Syndrome: An Information-processing Approach to Amnesia. Academic Press: New York.Google Scholar
Caetano, R., Edwards, G., Oppenheim, A. N. & Taylor, C. (1978). Building a standardised alcoholism interview schedule. Drug and Alcohol Dependence 3, 185–197.CrossRefGoogle ScholarPubMed
Carlen, P. L., Wilkinson, D. A., Wortzman, G., Holgate, R., Cordingley, J., Lee, M. A., Huszar, L., Moddel, G., Singh, R., Kivaly, L. & Rankin, J. G. (1981). Cerebral atrophy and functional deficits in alcoholics without clinically apparent liver disease. Neurology 31, 377–385.CrossRefGoogle ScholarPubMed
Cutting, J. (1978). The relationship between Korsakoff's syndrome and ‘Alcoholic dementia’. British Journal of Psychiatry 132, 240–251.CrossRefGoogle Scholar
Glosser, G., Butters, N. & Kaplan, E. (1977). Visuoperceptual processes in brain-damaged patients on the digit symbol substitution tests. International Journal of Neuroscience 7, 59–66.CrossRefGoogle Scholar
Harper, C. (1983). The incidence of Wernicke's encephalopathy in Australia – a neuropathological study of 131 cases. Journal of Neurology, Neurosurgery and Psychiatry, 46, 593–597.CrossRefGoogle Scholar
Henderson, A. S. & Huppert, F. A. (1984). The problem of mild dementia. Psychological Medicine 14, 5–11.CrossRefGoogle ScholarPubMed
Hillbom, M. & Holm, L. (1986). Contribution of traumatic head injury to neuropsychological deficits in alcoholics. Journal of Neurology, Neurosurgery and Psychiatry 49, 1348–1353.CrossRefGoogle ScholarPubMed
Jacobson, R. R. (1986). The contribution of sex and drinking history to the CT brain scan changes in alcoholics. Psychological Medicine 16, 547–559.CrossRefGoogle Scholar
Jacobson, R. R. (1987). CT scan, psychometric and clinical studies of the Wernicke–Korsakoff syndrome. M.D. thesis, University of Cambridge.Google Scholar
Jacobson, R. R. (1989). Alcoholism, Korsakoff's syndrome and the frontal lobes. Behavioural Neurology 2 25–38.CrossRefGoogle ScholarPubMed
Jacobson, R. R. & Lishman, W. A. (1987). Selective memory loss and global intellectual deficits in alcoholic Korsakoff's syndrome. Psychological Medicine 17, 649–655.CrossRefGoogle ScholarPubMed
Jacobson, R. R. & Lishman, W. A. (1990). Cortical and diencephalic lesions in Korsakoff's syndrome: a clinical and CT scan study. Psychological Medicine 20, 63–75.CrossRefGoogle ScholarPubMed
Kapur, N. & Butters, N. (1977). Visuoperceptive deficits in long-term alcoholics and alcoholics with Korsakoff's psychosis. Journal of Studies on Alcohol 38, 2025–2035.CrossRefGoogle ScholarPubMed
Kapur, N. & Coughlan, A. K. (1980). Confabulation and frontal lobe dysfunction. Journal of Neurology, Neurosurgery and Psychiatry 43, 461–463.CrossRefGoogle ScholarPubMed
Kopelman, M. D. (1989). Remote and autobiographical memory, temporal context memory and frontal atrophy in Korsakoff and Alzheimer patients. Neuropsychologia 27, 437–460.CrossRefGoogle ScholarPubMed
Kopelman, M. D. & Corn, T. H. (1988). Cholinergic ‘blockade’ as a model for cholinergic depletion: a comparison of the memory deficits of those with Alzheimer-type dementia and the alcoholic Korsakoff syndrome. Brain 111, 1079–1110.CrossRefGoogle Scholar
Korsakoff, S. S. & Serbski, W. (1892). Ein Fall von polyneuritsche Psychose mit Autopsie. Archiv für Psychiatrie und Nervenkrankheiten 23, 112–134.CrossRefGoogle Scholar
Lezak, M. D. (1983). Neuropsychological Assessment. Oxford University Press: Oxford.Google Scholar
Lishman, W. A., Jacobson, R. R. & Acker, C. (1987). Brain damage in alcoholism: current concepts. Acta Medica Scandinavica, Supplementum 717, 5–17.CrossRefGoogle ScholarPubMed
Luria, A. R. (1969). Frontal lobe syndromes. In Handbook of Clinical Neurology, Vol 2 (ed. Vinken, P. J. & Bruyn, G. W.) pp. 725–757. North Holland: Amsterdam.Google Scholar
Mayes, A. R., Meudell, P. R. & Neary, D. (1978). Must amnesia be caused by either encoding or retrieval disorders? In Practical Aspects of Memory (ed. Morris, M. M. & Sykes, R. N.), pp. 712–719. Academic Press: London.Google Scholar
Mayes, A. R., Meudell, P. R. & Pickering, A. (1985). Is organic amnesia caused by a selective deficit in remembering contextual information? Cortex 21, 167–202.CrossRefGoogle ScholarPubMed
Miller, R. G. (1981). Simultaneous Statistical Inference. Springer-Verlag: New York.CrossRefGoogle Scholar
Moscovitch, M. (1982). Multiple dissociations of function in amnesia. In Human Memory and Amnesia (ed. Cermak, L. S.), pp. 337–370. Lawrence Erlbaum Associates: Hillsdale.Google Scholar
Nelson, H. E. (1976). A modified card sorting test sensitive to frontal lobe defects. Cortex 12, 313–324.CrossRefGoogle ScholarPubMed
Nelson, H. E. & O'Connell, A. (1978). Dementia: the estimation of premorbid intelligence using the New Adult Reading Test. Cortex 14, 234–244.CrossRefGoogle ScholarPubMed
Newcombe, F. (1969). Missile Wounds of the Brain. Oxford University Press: Oxford.Google Scholar
Oscar-Berman, M. (1973). Hypothesis testing and focusing behaviour during concept formation by amnesic Korsakoff patients. Neuropsychologia 11, 191–198.CrossRefGoogle ScholarPubMed
Parsons, O. A. & Leber, W. R. (1982). Alcohol, cognitive dysfunction and brain damage. In Alcohol and Health Monograph, No. 2, pp. 213–253. National Institute on Alcohol Abuse and Alcoholism: USGPO.Google Scholar
Ratcliff, G. (1979). Spatial thought, mental rotation and the right cerebral hemisphere. Neuropsychologia 17, 49–54.CrossRefGoogle ScholarPubMed
Reitan, R. M. (1969). Trail Making Test Manual for Administration and Scoring. Indianapolis Neuropsychological Laboratory, Indianapolis Medical Centre: Indianapolis.Google Scholar
Robinson, A. L., Heaton, R. K., Lehman, R. A. W. & Stilson, D. W. (1980). The utility of the Wisconsin Card Sorting Test in detecting and localising frontal lobe lesions. Journal of Consulting and Clinical Psychology 48, 605–614.CrossRefGoogle ScholarPubMed
Ron, M. A. (1983). The alcoholic brain: CT scan and psychological findings. Psychological Medicine Monograph Supplement 3.Google Scholar
Ron, M. A., Acker, W., Shaw, G. K. & Lishman, W. A. (1982). Computerised tomography of the brain in chronic alcoholics: a survey and follow-up study. Brain 105, 497–514.CrossRefGoogle ScholarPubMed
Saunders, J. B., Davis, M. & Williams, R. (1981). Do women develop alcohol liver disease more readily than men? British Medical Journal 282, 1140–1143CrossRefGoogle ScholarPubMed
Schacter, D. L., Harbluk, J. L. & McLachlan, J. (1984). Retrieval without recollection: an experimental analysis of source amnesia. Journal of Verbal Learning and Behaviour 23, 593–611.CrossRefGoogle Scholar
Schaeffer, K. W., Parsons, O. A. & Yohman, J. R. (1984). Neuropsychological differences between male familial and non-familial alcoholics and non-alcoholics. Alcoholism: Clinical and Experimental Research 8 347–351.CrossRefGoogle Scholar
Shimamura, A. P. (1986). Priming effects in amnesia: evidence for a dissociable memory function. Quarterly Journal of Experimental Psychology 38A, 619–644.CrossRefGoogle Scholar
Squire, L. R. (1982). Comparisons between forms of amnesia: some deficits are unique to Korsakoff's syndrome. Journal of Experimental Psychology. Learning, Memory and Cognition 8 (6), 560–571.CrossRefGoogle ScholarPubMed
Squire, L. (1986). Mechanisms of memory. Science 232, 1612–1619.CrossRefGoogle ScholarPubMed
Stuss, D. T. & Benson, D. F. (1986). The Frontal Lobes. Raven Press: New York.Google Scholar
Talland, G. A. (1965). Deranged Memory – A Psychonomic Study of the Amnesic Syndrome. Academic Press: New York.Google Scholar
Tarter, R. E. & Edwards, K. L. (1986). Multifactorial etiology of neuropsychological impairment in alcoholics. Alcoholism: Clinical and Experimental Research 10, 128–135.CrossRefGoogle ScholarPubMed
Tarter, R. E., Hegedus, A. M., Van Thiel, D. H., Schade, R. R., Gavalier, J. S. & Sturzl, T. E. (1984). Non-alcoholic cirrhosis associated with neuropsychological dysfunction in the absence of overt evidence of hepatic encephalopathy. Gastroenterology 86, 1421–1427.CrossRefGoogle Scholar
Victor, W., Adams, R. D. & Collins, G. H. (1971). The Wernicke–Korsakoff Syndrome. Blackwell Scientific Publications: Oxford.Google ScholarPubMed
Walker, D. W., Barnes, D. E., Zorneyzer, S. F., Hunter, B. E. & Kubaris, P. (1980). Neuronal loss in hippocampus induced by prolonged ethanol consumption in rats. Science 209, 711–713.CrossRefGoogle ScholarPubMed
Warrington, E. K. & Weiskrantz, L. (1968). New method of testing long-term retention with special reference to amnesic patients. Nature 217, 972–974.CrossRefGoogle ScholarPubMed
Warrington, E. K. & Weiskrantz, L. (1970). The amnesic syndrome: consolidation or retrieval? Nature 228, 628–630.CrossRefGoogle ScholarPubMed
Warrington, E. K. & Weiskrantz, L. (1974). The effect of prior learning on subsequent retention in amnesic patients. Neuropsychologia 12, 419–428.CrossRefGoogle ScholarPubMed
Wechsler, D. (1945). The Wechsler Memory Scale. Journal of Psychology 19, 87–95.CrossRefGoogle Scholar
Zangwill, O. L. (1966). The amnesic syndrome. In Amnesia (ed. Whitty, C. W. M. and Zangwill, O. L.), pp. 77–91. Butterworths: London.Google Scholar