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Crohn's disease (CD) and ulcerative colitis (UC) are chronic and debilitating inflammatory conditions of the gastrointestinal tract. Thiamine can deplete rapidly in CD and UC, which can lead to Wernicke's encephalopathy (WE), is an acute neurologic disorder. Our objective was to systematically review the presentation of WE in CD and UC. We conducted our search from inception using the MeSH terms "Crohn's disease," "ulcerative colitis," and "Wernicke's encephalopathy." Our search yielded 28 case studies reporting on 31 cases. CD was diagnosed in 21 cases, and UC in 10. The first signs of WE were nausea and vomiting (13 cases), double vision (10), blurred vision (10), and hearing loss (4). In 12 cases, partial or complete bowel resection was one of the etiologies of thiamine depletion. In nine cases, thiamine was not supplemented intramuscularly or intravenously while parenteral nutrition or glucose was given to the patient. In 10 cases, detailed descriptions of thiamine treatment were given. Thiamine treatment at suboptimal levels (7 of 10 cases) turned out to lead to residual cognitive deficits in three cases. In three cases with optimal treatment (1500 mg/d intravenously), complete remission of WE symptoms was achieved. Rapid treatment with high doses (500 mg, 3 times/d) of thiamine saves lives, and treats WE in its core symptomatology.

Introduction: Despite the interest in memory functioning in Korsakoff's syndrome (KS), visual working memory capacity in KS is still poorly understood. Results from the last decades on working memory limitations in KS appear to be mixed, clearly calling for further investigations.Method: We investigated visual working memory storage capacity of patients diagnosed with KS using a change detection paradigm. Nine patients diagnosed with KS and thirty age- and education- matched healthy controls were presented twice with 2, 3, 4, or 6 bars with different orientations and had to detect whether the orientation of the target bar had changed.Results: As a group, KS patients performed significantly worse than controls on all set sizes, with an average capacity of 1.13 items, compared to 1.75 items in the control participants. In case study analysis, 4 out of 9 patients performed significantly worse than control participants, while 5 had relatively intact visual working memory capacity. In patients, deficits in visual working memory could not be explained by other cognitive deficits.Conclusion: Based on these results, we conclude that visual working memory deficits are a prominent characteristic in some, but not all KS patients. Training visual working memory capacity could possibly optimize other cognitive difficulties in this population.

Contains fulltext : 219555.pdf (Publisher’s version ) (Open Access) Objective: Patients with Korsakoff's syndrome (KS) have difficulty carrying out tasks which rely on prospective memory (PM). Since remembering to carry out an action in the future is crucial for living independently, it is of primary interest to develop strategies that improve PM performance in KS patients. Design: The study employed a computer categorization task as an ongoing activity into which a PM task was embedded. We included episodic future thinking (EFT) and observational learning (Experiment 2) to boost PM. Methods: Experiment 1 evaluated the efficacy of EFT following written PM task instructions in ten KS patients. Due to floor-level PM performance in Experiment 1, Experiment 2 included an instructional video demonstrating the PM intention. In Experiment 2, twenty-six KS patients performed both conditions (EFT and no-EFT) at least 1 week apart, while twelve controls with alcohol use disorder without KS performed the no-EFT condition. In Experiment 2, the PM instructions were also shown through video (observational learning component). Mild cognitive impairment was assessed in a short test battery. Results: Experiment 1 showed overall floor performance in both conditions. Experiment 2 showed that KS patients performed PM tasks less accurately than the control group in the no-EFT condition. In Experiment 2, where the observational learning component was included, EFT improved PM performance in KS patients. This effect was driven by a sub-group of high-functioning KS patients. Conclusions: This study showed the value of an observational learning component together with EFT in improving PM performance, in relatively high-functioning KS patients. Practitioner points: KS patients performed the PM task less accurately than non-KS controls with alcohol use disorder, confirming PM impairment in this patient population. Controls with alcohol use disorder performed the PM task at ceiling level. Showing an instructional video demonstrating the PM intention improved PM performance and later recall of PM task instructions in KS patients. Episodic future thinking strategy improved PM performance in KS patients with relatively intact cognitive functioning. 15 p.

Performance validity tests (PVTs) and Symptom validity tests (SVTs) are developed to identify people that present false or exaggerated symptoms. Although a key factor of both types of tests includes relative insensitivity to cognitive disorders, the direct effects of amnesia have been poorly studied. Therefore, a sample of 20 patients diagnosed with Korsakoff Amnesia (KA) through neuropsychological assessment and 20 healthy comparisons (HC) were administered the Test of Memory Malingering (TOMM), the Structured Inventory of Malingered Symptomatology (SIMS), and the newly developed Visual Association Test - Extended (VAT-E). Our results show that KA patients scored systematically lower on the TOMM and VAT-E, while performance on the SIMS was comparable with healthy comparisons. Some KA patients were regarded as underperformers based on the TOMM and VAT-E, suggesting limitations in applying these instruments in severe amnesia. There was a strong interdependence of PVTs in logistic regression. We conclude that the TOMM and VAT-E are not fully robust against severe memory disorders and show a serious risk of false positives. Complete neuropsychological profile analysis is needed, and PVTs should be interpreted with caution in patients with suspected amnesia.

Spatial relations between landmarks can be represented by means of categories and coordinates. In the present research, this paradigm was applied to sketch maps based on information acquired in goal-directed behaviour of exploration of a university campus area. The first aim was to investigate whether categorical and coordinate information can be considered conceptually independent in sketch maps. The second aim was to assess which kind of distance measure served better to represent coordinate information in the present case study, and finally to assess the factorial structure of coordinate and categorical data. Analytic methodology as well as statistical analysis were found to confirm that separating coordinate and categorical components was formally as well as empirically appropriate. A series of confirmatory factor analyses showed the best fit for the model with two correlated components, as well as an acceptable reliability of measures emerged. The two components were moderately correlated. Moreover, the adoption of Manhattan distance seemed to be the most effective method to represent coordinate spatial relations in spatial sketch maps of areas acquired through navigation.