Beyond Thiamine: Treatment for Cognitive Impairment in Korsakoff’s Syndrome

Johnson, Justin M.; Fox, Valerie

doi:10.1016/j.psym.2018.03.011

Cited by 28 publications

(16 citation statements)

References 34 publications

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“…Episodic and semantic memories are commonly affected while implicit memory usually remains intact. Patients frequently confabulate and compensate for these gaps in memory by replacing them with untrue facts [13,14]. KS is accounted for by alcoholism in 95% of cases [15].…”

Section: Discussionmentioning

confidence: 99%

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Wernicke Encephalopathy in an Elderly Patient Due to Chronic Malnutrition From an Atypical Diet

Shah

Moronta

Braford

et al. 2021

Cureus

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Wernicke encephalopathy has traditionally been associated with chronic alcohol abuse leading to thiamine deficiency. Clinical symptoms include mentation change, gait ataxia, and oculomotor abnormalities. However, it is often an underdiagnosed condition in patients suffering from chronic malnutrition, especially in the West. We examine a unique case of non-alcoholic Wernicke encephalopathy in an elderly patient.The patient had a long history of chronic malnutrition due to her atypical diet, consuming an unbalanced diet deprived of thiamine, unbeknownst to her. She presented with symptoms of encephalopathy, recurrent falls, and pupillary changes. After exhausting all other therapeutic interventions, she received a thiamine infusion; her mentation and other symptoms improved dramatically.Thiamine deficiency can lead to severe complications, including Wernicke encephalopathy and cardiomyopathy. Wernicke encephalopathy can progress to Korsakoff syndrome, which is characterized by amnesia and confabulation. Case reports, such as ours, may remind clinicians to keep thiamine deficiency as a viable differential while evaluating acute encephalopathy, especially in the malnourished geriatric population.

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Section: Discussionmentioning

confidence: 99%

“…However, there are several reports of nonalcoholic KS in which no atrophy was seen on MRI. Therefore, although changes in periventricular areas are present in half of the cases of WE, and they can support a clinical suspicion of KS, diagnosis of KS should not rely solely on imaging [14,15,16].…”

Section: Discussionmentioning

confidence: 99%

Wernicke Encephalopathy in an Elderly Patient Due to Chronic Malnutrition From an Atypical Diet

Shah

Moronta

Braford

et al. 2021

Cureus

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“…This is consistent with newer evidence suggesting that some recovery from the deficits seen in KS is possible. 3 Once diagnosed, the treatment objective is the replenishment of thiamine stores and optimization of the metabolic scenario of the body to prevent recurrence. For acute WE symptoms, many regimens call for 250 to 500 mg of IV thiamine supplementation 2 to 3 times daily for 3 to 5 days.…”

Section: Discussionmentioning

confidence: 99%

“…2 A review published in 2018, for example, gathered several case reports and case series that suggest significant improvement in memory and cognition attributed to behavioral and pharmacologic interventions, indicating this as an area deserving of further study. 3 About 20% of patients diagnosed with WE by autopsy exhibited none of the classical triad symptoms prior to death. 4 Hence, these conditions are surmised to be significantly underdiagnosed and misdiagnosed.…”

mentioning

confidence: 99%

An Atypical Long-Term Thiamine Treatment Regimen for Wernicke Encephalopathy

Shoaib¹,

Hyder²,

May³

2020

Federal Practitioner

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“…In humans, diffusion-weighted imaging studies revealed several tracts that connect with the MB, such as the fornix and mammillotegmental tract (Granziera et al, 2011;Kwon et al, 2011;Mori and Aggarwal, 2014;Christiansen et al, 2016;Cacciola et al, 2017;Wei et al, 2017;Kamali et al, 2018;Choi et al, 2019;Maller et al, 2019). Clinical studies also revealed that memory-impaired patients with Korsakoff syndrome exhibit atrophy of the MB (Squire et al, 1990;Harding et al, 2000;Tsivilis et al, 2008;Fama et al, 2012;Kril and Harper, 2012;Aggleton, 2014;Kopelman, 2015;Isenberg-Grzeda et al, 2016;Arts et al, 2017;Johnson and Fox, 2018). However, the lateralmedial dissociation in the MB is much less evident in humans than in animals.…”

Section: Introductionmentioning

confidence: 99%

Dissociable Networks of the Lateral/Medial Mammillary Body in the Human Brain

Tanaka

Osada

Ogawa

et al. 2020

Front. Hum. Neurosci.

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The mammillary body (MB) has been thought to implement mnemonic functions. Although recent animal studies have revealed dissociable roles of the lateral and medial parts of the MB, the dissociable roles of the lateral/medial MB in the human brain is still unclear. Functional connectivity using resting-state functional magnetic resonance imaging (fMRI) provides a unique opportunity to noninvasively inspect the intricate functional organization of the human MB with a high degree of spatial resolution. The present study divided the human MB into lateral and medial parts and examined their functional connectivity with the hippocampal formation, tegmental nuclei, and anterior thalamus. The subiculum of the hippocampal formation was more strongly connected with the medial part than with the lateral part of the MB, whereas the pre/parasubiculum was more strongly connected with the lateral part than with the medial part of the MB. The dorsal tegmental nucleus was connected more strongly with the lateral part of the MB, whereas the ventral tegmental nucleus showed an opposite pattern. The anterior thalamus was connected more strongly with the medial part of the MB. These results confirm the extant animal literature on the lateral/medial MB and provide evidence on the parallel but dissociable systems involving the MB that ascribe mnemonic and spatialnavigation functions to the medial and lateral MBs, respectively.

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Beyond Thiamine: Treatment for Cognitive Impairment in Korsakoff’s Syndrome

Cited by 28 publications

References 34 publications

Wernicke Encephalopathy in an Elderly Patient Due to Chronic Malnutrition From an Atypical Diet

Wernicke Encephalopathy in an Elderly Patient Due to Chronic Malnutrition From an Atypical Diet

An Atypical Long-Term Thiamine Treatment Regimen for Wernicke Encephalopathy

Dissociable Networks of the Lateral/Medial Mammillary Body in the Human Brain

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