Neurochemical pathology in Korsakoff's psychosis: implications for other cognitive disorders

There seems to be an anatomic correspondence between pathways of monoamine-containing neurons and the brainstem and diencephalic lesions associated with Korsakoff's psychosis. In 25 patients with Korsakoff's disease, we found that CSF levels of metabolites of norepinephrine, dopamine, and serotonin were significantly lower than in controls. Norepinephrine metabolite levels were reduced more consistently and extensively than those of dopamine and serotonin. The 25 patients had circumscribed cognitive deficits, but were not demented. We argue that norepinephrine-containing neurons are selectively damaged in Korsakoff's psychosis and that lesions of brain monoamine-containing neurons cause specific cognitive impairments, not global dementia.