Scalzo Simon J, Bowden Stephen C
Melbourne School of Psychological Sciences, Redmond Barry Building, University of Melbourne, Parkville, VIC 3010, Australia.
Centre for Clinical Neuroscience & Neurological Research, St Vincent's Hospital Melbourne, Fitzroy, VIC 3065, Australia.
J Clin Med. 2023 Oct 31;12(21):6880. doi: 10.3390/jcm12216880.
The aim of this study was to objectively evaluate the hypothesis that the neuropsychological presentation of Korsakoff's syndrome, the chronic phase of Wernicke-Korsakoff syndrome (WKS), is invariably a severe, selective amnesia against a background of relatively preserved general intellectual functions in a consecutive clinical sample. An analysis of the neuropsychological profiles of nine cases with a recorded history of WKS was undertaken. All cases were adult males (ages 32 to 70) with a long history of alcohol use disorder. Eight cases were chosen retrospectively on a consecutive basis from patient referrals. One additional case was recruited prospectively. Conventional understanding and some current opinion of Korsakoff's syndrome predicts anterograde memory to be consistently more impaired than other cognitive abilities, but this was not found in this case series. The Mean Wechsler Delayed Memory Index was not significantly different from the Wechsler Full-Scale IQ (FSIQ), = 0.130. Regression of Delayed Memory on FSIQ produced a non-significant intercept, = 0.213. The 'hallmark' criterion of anterograde memory score at least 20 points less than intelligence score was observed in four of eight cases with available data, equating to a 'sensitivity' of 50%. Three of eight cases with available data had an FSIQ less than the memory score. Contrary to a common view, general intellectual function was not consistently preserved in Korsakoff's syndrome relative to memory function. This study illustrates one of the specific merits of case series, namely, to critique an established view. Clinicians and researchers should expand their diagnostic criteria for Korsakoff's syndrome to include more variable cognitive phenotypes, including a potentially reversible dementia-like impairment of variable severity, and focus on potential treatment opportunities.
韦尼克-科尔萨科夫综合征（WKS）慢性阶段的科尔萨科夫综合征的神经心理学表现始终是在连续临床样本中相对保留的一般智力功能背景下的严重、选择性失忆。对9例有WKS病史记录的患者的神经心理学概况进行了分析。所有病例均为成年男性（年龄32至70岁），有长期酒精使用障碍史。8例是从患者转诊中连续回顾性选取的。另外1例是前瞻性招募的。对科尔萨科夫综合征的传统理解和一些当前观点预测，顺行性记忆始终比其他认知能力受损更严重，但在这个病例系列中未发现这种情况。韦氏延迟记忆指数的平均值与韦氏全量表智商（FSIQ）无显著差异，P = 0.130。延迟记忆对FSIQ的回归产生了一个不显著的截距，P = 0.213。在8例有可用数据的病例中，有4例观察到顺行性记忆得分比智力得分至少低20分的“标志性”标准，相当于“敏感性”为50%。8例有可用数据的病例中有3例的FSIQ低于记忆得分。与普遍观点相反，相对于记忆功能，科尔萨科夫综合征中的一般智力功能并非始终得到保留。本研究说明了病例系列的一个具体优点，即对既定观点进行批判。临床医生和研究人员应扩大科尔萨科夫综合征的诊断标准，以纳入更多可变的认知表型，包括潜在可逆的不同严重程度的痴呆样损害，并关注潜在的治疗机会。
