Pitel Anne Lise, Beaunieux Hélène, Witkowski Thomas, Vabret François, de la Sayette Vincent, Viader Fausto, Desgranges Béatrice, Eustache Francis
Inserm-EPHE-Université de Caen/Basse-Normandie, Unité U923, GIP Cyceron, CHU Côte de Nacre, Caen, France.
Alcohol Clin Exp Res. 2008 Jul;32(7):1229-41. doi: 10.1111/j.1530-0277.2008.00677.x.
The exact nature of episodic and working memory impairments in alcoholic Korsakoff patients (KS) remains unclear, as does the specificity of these neuropsychological deficits compared with those of non-Korsakoff alcoholics (AL). The goals of the present study were therefore to (1) specify the nature of episodic and working memory impairments in KS, (2) determine the specificity of the KS neuropsychological profile compared with the AL profile, and (3) observe the distribution of individual performances within the 2 patient groups.
We investigated episodic memory (encoding and retrieval abilities, contextual memory and state of consciousness associated with memories), the slave systems of working memory (phonological loop, visuospatial sketchpad and episodic buffer) and executive functions (inhibition, flexibility, updating and integration abilities) in 14 strictly selected KS, 40 AL and 55 control subjects (CS).
Compared with CS, KS displayed impairments of episodic memory encoding and retrieval, contextual memory, recollection, the slave systems of working memory and executive functions. Although episodic memory was more severely impaired in KS than in AL, the single specificity of the KS profile was a disproportionately large encoding deficit. Apart from organizational and updating abilities, the slave systems of working memory and inhibition, flexibility and integration abilities were impaired to the same extent in both alcoholic groups. However, some KS were unable to complete the most difficult executive tasks. There was only a partial overlap of individual performances by KS and AL for episodic memory and a total mixture of the 2 groups for working memory.
Korsakoff's syndrome encompasses impairments of the different episodic and working memory components. AL and KS displayed similar profiles of episodic and working memory deficits, in accordance with neuroimaging investigations showing similar patterns of brain damage in both alcoholic groups.
酒精性柯萨科夫综合征（KS）患者发作性记忆和工作记忆损害的确切性质仍不清楚，与非柯萨科夫酒精性患者（AL）相比，这些神经心理学缺陷的特异性也不明确。因此，本研究的目的是：（1）明确KS患者发作性记忆和工作记忆损害的性质；（2）确定KS患者神经心理学特征与AL患者相比的特异性；（3）观察两个患者组内个体表现的分布情况。
我们对14名严格筛选的KS患者、40名AL患者和55名对照受试者（CS）的发作性记忆（编码和检索能力、情境记忆以及与记忆相关的意识状态）、工作记忆的附属系统（语音环路、视觉空间画板和情景缓冲器）以及执行功能（抑制、灵活性、更新和整合能力）进行了研究。
与CS相比，KS患者在发作性记忆编码和检索、情境记忆、回忆、工作记忆的附属系统以及执行功能方面存在损害。虽然KS患者的发作性记忆损害比AL患者更严重，但KS患者特征的唯一特异性是编码缺陷 disproportionately 大。除了组织和更新能力外，两个酒精性患者组的工作记忆附属系统以及抑制、灵活性和整合能力受损程度相同。然而，一些KS患者无法完成最困难的执行任务。KS患者和AL患者在发作性记忆方面的个体表现只有部分重叠，而在工作记忆方面两组完全混合。
柯萨科夫综合征包括不同发作性和工作记忆成分的损害。AL患者和KS患者在发作性和工作记忆缺陷方面表现出相似的特征，这与神经影像学研究结果一致，即两个酒精性患者组的脑损伤模式相似。
