Magnetic resonance imaging in alcoholic Korsakoff's syndrome: evidence for an association with alcoholic dementia.

A magnetic resonance imaging study of 19 alcoholic Korsakoff patients, 17 non-amnesic alcoholics and 23 non-alcoholic controls was undertaken. Several measures of ventricular size and interhemispheric area were significantly greater in the Korsakoff patients. Interhemispheric fissure size was greater in the non-amnesic alcoholics than the non-alcoholic controls. Cortical grey matter T1 values were essentially the same for the three groups, whereas the deep grey and the white matter T1 values for the Korsakoff patients were significantly greater than the non-alcoholic controls. These results indicate widespread cerebral atrophy in alcoholic Korsakoff patients, which is largely subcortical and does not develop independently of the diencephalic pathology. Alcoholic dementia may be a more severe form of alcoholic Korsakoff syndrome, aetiologically related to the nutritionally-induced diencephalic pathology, rather than the neurotoxic effects of alcohol on the cortex.

Vasopressin secretion and memory impairment in alcoholic Korsakoff's syndrome.

The response of arginine vasopressin (AVP) to an intravenous hypertonic saline infusion was investigated in 19 patients with alcoholic Korsakoff's syndrome, 17 non-amnesic alcoholics and 21 non-alcoholic controls. Compared with non-alcoholic controls the Korsakoff patients had elevated basal AVP levels and showed erratic fluctuation of AVP secretion, not related to changes in serum sodium levels. The non-amnesic alcoholics had a similar, but less severe derangement. Neuropsychological tests revealed significant correlations between basal AVP levels and memory performance in the non-amnesic alcoholics, raising the possibility of a common lesion--most likely in the diencephalon--for memory impairment and AVP dysregulation in chronic alcoholics.