Alcoholic Korsakoff's syndrome: some unresolved issues concerning etiology, neuropathology, and cognitive deficits

Recent neuropsychological and neuropathological investigations with long-term alcoholics suggest that the etiology and neuropathology of the Wernicke-Korsakoff syndrome are more complex than previously believed. While problem solving and visuoperceptual deficits seem to develop slowly during decades of alcoholism, the amnesic symptoms associated with Korsakoff's syndrome may appear acutely when severe malnutrition and alcoholism are combined. Furthermore, the report that alcoholic Korsakoff patients, like patients with Alzheimer's Disease, have endured a substantial neuronal loss in the nucleus basalis of Meynert has questioned the role of the medial diencephalon in the alcoholic patients' amnesic syndrome. Some initial demonstrations of similarities in the memory disorders of alcoholic Korsakoff and Alzheimer patients indicate that Korsakoff's syndrome may be more accurately characterized as a "basal forebrain" than as a "diencephalic" amnesia.