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Temporal Cognitive and Brain Changes in Korsakoff Syndrome
- Source :
- Neurology, Neurology, American Academy of Neurology, 2021, 96 (15), pp.e1987-e1998. ⟨10.1212/WNL.0000000000011749⟩
- Publication Year :
- 2020
-
Abstract
- ObjectiveTo investigate cognitive and brain changes in patients with Korsakoff syndrome (KS) over months and up to 10 years after the diagnosis.MethodsTwo groups of 8 patients with KS underwent neuropsychological, motor, and neuroimaging investigations, including structural MRI and 18F-fluorodeoxyglucose-PET. The KSC group, recruited at Caen University Hospital, was examined early after the KS diagnosis (KSC-T1) and 1 year later (KSC-T2). The KSR group, recruited at nursing home at Roubaix, was evaluated 10 years after the diagnosis. Longitudinal comparisons in KSC explored short-term changes, while cross-sectional comparisons between KSC-T1 and KSR informed about long-term changes.ResultsNo cognitive, motor, or brain deterioration occurred over time in patients with KS. There was no clear improvement either, with only modest recovery in the frontocerebellar circuit. Compared to the norms, KSC-T1 had severe episodic memory impairments, ataxia, and some executive dysfunctions. They also presented widespread atrophy and hypometabolism as well as cerebellar hypermetabolism compared to 44 healthy matched controls. Episodic memory remained significantly impaired in KSC-T2 and KSR. Contrary to KSC at T1 and T2, KSR had preserved inhibition abilities. Atrophy was similar but less extended in KSC-T2 and even more limited in KSR. At all times, the thalamus, hypothalamus, and fornix remained severely atrophied. Hypometabolism was still widespread in KSC-T2 and KSR, notably affecting the diencephalon. Cerebellar metabolism decreased over time and normalized in KSR, whereas motor dysfunction persisted.ConclusionIn KS, structural and metabolic alterations of the Papez circuit persisted over time, in accordance with the irreversible nature of amnesia. There was neither significant recovery as observed in patients with alcohol use disorder nor progressive decline as in neurodegenerative diseases.
- Subjects :
- Adult
Male
Ataxia
Amnesia
Physiology
[SHS.PSY]Humanities and Social Sciences/Psychology
03 medical and health sciences
0302 clinical medicine
Atrophy
Cognition
Medicine
Humans
Cognitive Dysfunction
Longitudinal Studies
Episodic memory
Aged
business.industry
Papez circuit
[SCCO.NEUR]Cognitive science/Neuroscience
Fornix
Neuropsychology
Brain
Middle Aged
medicine.disease
030227 psychiatry
medicine.anatomical_structure
Cross-Sectional Studies
Korsakoff Syndrome
Hypermetabolism
Disease Progression
Female
Neurology (clinical)
medicine.symptom
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 1526632X and 00283878
- Volume :
- 96
- Issue :
- 15
- Database :
- OpenAIRE
- Journal :
- Neurology
- Accession number :
- edsair.doi.dedup.....5803741cf9ba622267a249864d41ff09