Elsevier

Cortex

Volume 39, Issues 4ā€“5, 2003, Pages 1027-1045
Cortex

Special Issue
FDG-PET Findings in the Wernicke-Korsakoff Syndrome

https://doi.org/10.1016/S0010-9452(08)70876-1Get rights and content

Abstract

This study reports FDG-PET findings in Wernicke-Korsakoff patients. Twelve patients suffering amnesia arising from the Korsakoff syndrome were compared with 10 control subjects without alcohol-related disability. Subjects received [18F]-fluorodeoxyglucose (FDG-PET) imaging as well as neuropsychological assessment and high-resolution MR imaging with volumetric analysis. Volumetric MRI analysis had revealed thalamic and mamillary body atrophy in the patient group as well as frontal lobe atrophy with relative sparing of medial temporal lobe structures. Differences in regional metabolism were identified using complementary region of interest (ROI) and statistical parametric mapping (SPM) approaches employing either absolute methods or a reference region approach to increase statistical power. In general, we found relative hypermetabolism in white matter and hypometabolism in subcortical grey matter in Korsakoff patients. When FDG uptake ratios were examined with occipital lobe metabolism as covariate reference region, Korsakoff patients showed widespread bilateral white matter hypermetabolism on both SPM and ROI analysis. When white matter metabolism was the reference covariate, Korsakoff patients showed relative hypometabolism in the diencephalic grey matter, consistent with their known underlying neuropathology, and medial temporal and retrosplenial hypometabolism, interpreted as secondary metabolic effects within the diencephalic-limbic memory circuits. There was also evidence of a variable degree of more general frontotemporal neocortical hypometabolism on some, but not all, analyses.

References (64)

  • MS Albert et al.

    Temporal gradients in the retrograde amnesia of patients with alcoholic Korsakoff's disease

    Archives of Neurology

    (1979)
  • N Berlyne

    Confabulation

    British Journal of Psychiatry

    (1972)
  • N Butters et al.

    Alcoholic Korsakoff's syndrome: An Information-Processing Approach to Amnesia

    (1980)
  • RF Butterworth

    Effects of thiamine deficiency on brain metabolism: Implications for the pathogenesis of the Wernicke-Korsakoff Syndrome

    Alcohol and Alcoholism

    (1989)
  • PL Carlen et al.

    Cerebral atrophy and functional deficits in alcoholics without apparent liver disease

    Neurology

    (1981)
  • ME Charness

    Brain lesions in alcoholics

    Alcoholism: Clinical and Experimental Research

    (1993)
  • JE Christie et al.

    Magnetic resonance imaging in presenile dementia of the Alzheimer type, multi-infarct dementia and Korsakoff's syndrome

    Psychological Medicine

    (1988)
  • A Colchester et al.

    Structural MRI volumetric analysis in patients with organic amnesia: Methods and comparative findings across diagnostic groups

    Journal of Neurology, Neurosurgery and Psychiatry

    (2001)
  • J Cutting

    The relationship between Korsakoff's syndrome and ā€œalcoholic dementiaā€

    British Journal of Psychiatry

    (1978)
  • B Desgranges et al.

    The neural substrates of memory systems impairment in Alzheimer's disease: A PET study of resting brain glucose utilization

    Brain

    (1998)
  • R Emsley et al.

    Magnetic resonance imaging in alcoholic Korsakoff's syndrome: Evidence for an association with alcoholic dementia

    Alcohol and Alcoholism

    (1996)
  • F Fazio et al.

    Metabolic impairment in human amnesia: A PET study of memory networks

    Journal of Cerebral Blood Flow Metabolism

    (1992)
  • KJ Friston et al.

    Spatial registration and normalization of images

    Human Brain Mapping

    (1995)
  • KJ Friston et al.

    Statistical parametric maps in functional imaging: A general linear approach

    Human Brain Mapping

    (1995)
  • S Gilman et al.

    Cerebellar and frontal hypometabolism in alcoholic cerebellar degeneration studied with positron emission tomography

    Annals of Neurology

    (1990)
  • I Grant

    Alcohol and the brain: Neuropsychological correlates

    Journal of Consulting and Clinical Psychology

    (1987)
  • LD Griffin et al.

    Hierarchical segmentation satisfying constraints

  • A Harding et al.

    Degeneration of anterior thalamic nuclei differentiates alcoholics with amnesia

    Brain

    (2000)
  • CG Harper et al.

    If you drink your brain will shrink. Neuropathological considerations

    Alcohol and Alcohol Supplement

    (1991)
  • CG Harper et al.

    Are we drinking our neurones away?

    British Medical Journal

    (1987)
  • CG Harper et al.

    The effects of alcohol on the female brain: A neuropathological study

    Alcohol and Alcoholism

    (1990)
  • T Hata et al.

    Three-dimensional mapping of local cerebral perfusion in alcoholic encephalopathy with and without Wernicke-Korsakoff syndrome

    Journal of Cerebral Blood Flow Metabolism

    (1987)
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      Pathological changes in gray matter morphology, whether developmental (as in schizophrenia, bipolar and autism spectrum disorders) or neurodegenerative (as in various dementing conditions), leading to its expansion or loss, will necessarily engender maladaptive connectivity and heightened expenditure of energy in the white matter. Thus, increased glucose metabolism in the white matter has been shown in several pathological and experimental conditions of autoimmune, inflammatory, toxic, and traumatic etiology, such as with elevated intracranial pressure in idiopathic hydrocephalus syndrome (ƅgren-Wilsson et al., 2003) and experimental tissue compression (Floeth et al., 2013), in early systemic lupus erythematosus (Ramage et al., 2011), Wernicke-Korsakoff syndrome (Reed et al., 2003), experimental autoimmune encephalomyelitis (Radu et al., 2007; Buck et al., 2012), after cerebral irradiation (Esik et al., 1999, 2004) and carbon monoxide intoxication (Chou et al., 2019). Given the transient and reversible character of metabolic impairments in these conditions, they have been hypothesized to be due to dysmyelination, i.e. with implicit assumption of reductions in fractional anisotropy.

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