Clinical and pathological features of alcohol-related brain damage
Top Cited Papers
- 12 April 2011
- journal article
- review article
- Published by Springer Science and Business Media LLC in Nature Reviews Neurology
- Vol. 7 (5), 284-294
- https://doi.org/10.1038/nrneurol.2011.42
Abstract
Numerous neurological consequences of alcoholism have been identified, including hepatic encephalopathy, Wernicke encephalopathy, Korsakoff syndrome, Marchaifava–Bignami disease and central pontine myelinosis. Here, Zahr et al. focus on Wernicke encephalopathy and Korsakoff syndrome, exploring their position within a proposed spectrum of neurological disruption that begins with alcohol-related brain damage. One of the sequelae of chronic alcohol abuse is malnutrition. Importantly, a deficiency in thiamine (vitamin B1) can result in the acute, potentially reversible neurological disorder Wernicke encephalopathy (WE). When WE is recognized, thiamine treatment can elicit a rapid clinical recovery. If WE is left untreated, however, patients can develop Korsakoff syndrome (KS), a severe neurological disorder characterized by anterograde amnesia. Alcohol-related brain damage (ARBD) describes the effects of chronic alcohol consumption on human brain structure and function in the absence of more discrete and well-characterized neurological concomitants of alcoholism such as WE and KS. Through knowledge of both the well-described changes in brain structure and function that are evident in alcohol-related disorders such as WE and KS and the clinical outcomes associated with these changes, researchers have begun to gain a better understanding of ARBD. This Review examines ARBD from the perspective of WE and KS, exploring the clinical presentations, postmortem brain pathology, in vivo MRI findings and potential molecular mechanisms associated with these conditions. An awareness of the consequences of chronic alcohol consumption on human behavior and brain structure can enable clinicians to improve detection and treatment of ARBD.Keywords
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