Eva Lucian, Brehar Felix-Mircea, Florian Ioan-Alexandru, Covache-Busuioc Razvan-Adrian, Costin Horia Petre, Dumitrascu David-Ioan, Bratu Bogdan-Gabriel, Glavan Luca-Andrei, Ciurea Alexandru Vlad
Faculty of Medicine, Dunarea de Jos University, 800010 Galati, Romania.
Department of Neurosurgery, Clinical Emergency Hospital "Prof. Dr. Nicolae Oblu", 700309 Iasi, Romania.
J Clin Med. 2023 Sep 21;12(18):6101. doi: 10.3390/jcm12186101.
Alcohol-related cognitive disorders have long been an area of study, yet they continue to pose challenges in the diagnosis, treatment, and understanding of underlying neuropsychiatric mechanisms. The present article offers a comprehensive review of Wernicke's Encephalopathy and Korsakoff's Syndrome, two conditions often seen on a continuum of alcohol-related brain damage. Drawing on current medical literature, neuroimaging studies, and clinical case reports, we explore the neuropsychiatric and neuropsychological profiles, symptomatology, and differential diagnoses of these disorders. We delve into the biochemical pathways implicated in the development of WE and KS, notably thiamine deficiency and its impact on neurotransmitter systems and neural networks. The article also addresses the challenges in early diagnosis, often complicated by non-specific symptoms and co-occurring psychiatric conditions. Furthermore, we review the current state of treatment protocols, including pharmacological and non-pharmacological interventions. Finally, the article highlights gaps in current knowledge and suggests directions for future research to improve diagnosis, treatment, and patient outcomes. Understanding the nuanced interplay between the neuropsychiatric and neuropsychological aspects of WE and KS is crucial for both clinicians and researchers alike, in order to provide effective treatment and to advance our understanding of these complex conditions.
长期以来，酒精相关认知障碍一直是研究领域，但在诊断、治疗以及对潜在神经精神机制的理解方面，它们仍然构成挑战。本文全面综述了韦尼克脑病和科萨科夫综合征，这两种病症常出现在酒精相关脑损伤的连续谱中。借助当前医学文献、神经影像学研究和临床病例报告，我们探讨了这些疾病的神经精神和神经心理学特征、症状表现及鉴别诊断。我们深入研究了与韦尼克脑病和科萨科夫综合征发生发展相关的生化途径，尤其是硫胺素缺乏及其对神经递质系统和神经网络的影响。本文还讨论了早期诊断面临的挑战，这些挑战往往因非特异性症状和并发的精神疾病而变得复杂。此外，我们回顾了当前治疗方案的现状，包括药物和非药物干预措施。最后，本文强调了当前知识的空白，并提出了未来研究的方向，以改善诊断、治疗和患者预后。理解韦尼克脑病和科萨科夫综合征神经精神和神经心理学方面的细微相互作用，对临床医生和研究人员来说都至关重要，以便提供有效的治疗并增进我们对这些复杂病症的理解。
