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1.
Ethiop. Med. j ; 61(2): 121-129, 2023. tables, figures
Artigo em Inglês | AIM (África) | ID: biblio-1426877

RESUMO

Background: Daily alcohol consumption above recommended limits is an important cause of Alcoholic Lher Disease. Hence, this study aimed to assess the knowledge of Alcoholic Liver Disease among alcohol consumers and screenfor alcohol misuse, dependence, and disorder. Methods: A community-based cross-sectional survey using simple random sampling technique was conducted on residents ofÅfikpo age 15 and above who consume alcohol using a structured questionnaire to obtain information on alcoholic use disorder and alcohol dependence. The sample size Itas determined Il'ith the aid of a Raosoft sample size calculator. Data obtained was entered into an excel spreadsheetfor data cleaning. The frequency, percentages and mean and Standard deviation was also obtained. Data was exported into IBM SPSS to determine the relationship behre.en knou:ledge of Alcoholic Liver Disease and demographic variables using One-way ANOL4 and Chi-Square Il'here appropriate at P-value <0.05 and 5% significance level. Results: The total number of study participants was 435 with a response rate of 97%. Out of which had a good knowledge of Alcoholic Liver Disease. Adults above the age of 60 had a mean audit score of 12.808 Il'hile male respondents had a mean audit score of 11.395. Adolescents had a mean CAGE test score of 1.89 while adults above 60 scored 2.48. Hou•ever, participants with no education had the highest mean CAGE score of2.27. The males had good knowledge ofAlcoholic Liver Disease. (P 0.006). Conclusion: The residents ofÅfikpo community have a good knowledge ofAlcoholic Lher Disease though there is alcohol use disorder, alcohol misuse and dependence amongst residents in the community. Gender is the only demographic characteristics that influenced the knowledge ofAlcoholic Liver Disease


Assuntos
Humanos , Transtorno Amnésico Alcoólico , Hepatopatias Alcoólicas , Terapêutica , Alcoolismo , Dieta Saudável
3.
Cogn Neuropsychiatry ; 27(4): 296-313, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35477346

RESUMO

INTRODUCTION: Alwyn Lishman was interested in how memory research could be applied to clinical psychiatry. After a brief review of his major contributions, this paper will focus on his research on the alcoholic Korsakoff syndrome. It will consider how his findings relate to contemporary debates, particularly on how the syndrome should be defined, and its relationship to broader alcohol-induced cognitive impairments. METHODS: A review of the contribution of Alwyn Lishman, Robin Jacobson and colleagues to our knowledge of Korsakoff's syndrome, together with a review of the pertinent recent literature. RESULTS: Lishman and colleagues followed earlier authors in defining the Korsakoff syndrome in terms of disproportionate memory impairment, but they also noted a variable degree of IQ, frontal-executive, and timed visuo-spatial impairment in their cases. More recent authors have included such features in their definitions of the syndrome. Lishman also argued for a specific "alcoholic dementia". The present paper argues that recent definitions of the Korsakoff syndrome confound its core and associated features, and also fail to recognise the multifactorial basis of alcohol-related brain damage. CONCLUSIONS: Korsakoff's syndrome is best defined in terms of disproportionate memory impairment, and more widespread cognitive impairment is best encompassed within "alcohol-related brain damage".


Assuntos
Transtorno Amnésico Alcoólico , Alcoolismo , Disfunção Cognitiva , Síndrome de Korsakoff , Encefalopatia de Wernicke , Transtorno Amnésico Alcoólico/complicações , Transtorno Amnésico Alcoólico/psicologia , Alcoolismo/psicologia , Humanos , Síndrome de Korsakoff/complicações , Transtornos da Memória , Encefalopatia de Wernicke/complicações
4.
Neurosci Biobehav Rev ; 130: 292-300, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34454914

RESUMO

The pathophysiological mechanisms behind amnesia are still unknown. Recent literature, through the study of patients with Alcohol Use Disorder with and without Korsakoff's syndrome, increasingly shows that physiological alterations to the thalamus have an important role in the development of amnesia. This review gives an overview of neuropsychological, neuropathological and neuroimaging contributions to the understanding of Korsakoff's syndrome, highlighting the central role of the thalamus in this amnesia. The thalamus being a multi-nucleus structure, the limitations regarding the loci, nature and alterations to specific nuclei are discussed, along with potential solutions. Finally, future directions for clinical research are laid out to unravel the intricacies inherent to amnesia. They consider the need to evaluate the physiological role of the thalamus, not only as an entity but also as part of a brain circuit through a more integrative approach.


Assuntos
Transtorno Amnésico Alcoólico , Alcoolismo , Síndrome de Korsakoff , Amnésia , Humanos , Tálamo
5.
Bull Exp Biol Med ; 167(6): 723-727, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31655996

RESUMO

We studied the involvement of cAMP/PKA signaling in the realization of the growth potential of neural progenitors and secretion of neurotrophic growth factors by glial elements under conditions of ethanol-induced neurodegeneration in vitro and in vivo. The stimulating role of cAMP and PKA in cell cycle progression of the neural progenitor cells and in production of neurotrophins by the cells in nervous tissue under the optimal conditions to vital activity was demonstrated. Ethanol inverted the role of cAMP/PKA signaling pathways in determination of the proliferation-differentiation status of neural stem cells. Selective blockade of adenylate cyclase or PKA in neural stem cells increased the rate of their division against the background of relative decrease in differentiation rate. In addition, cAMP/PKA signaling does not longer participate in neurotrophin production by glial cells in neurodegeneration. These findings suggest that inhibitors of activity/expression of adenylate cyclase and PKA can be considered as possible drugs with regenerative activity for the treatment of nervous system pathologies provoked by alcohol.


Assuntos
Inibidores de Adenilil Ciclases/farmacologia , Transtorno Amnésico Alcoólico/fisiopatologia , Proteínas Quinases Dependentes de AMP Cíclico/fisiologia , AMP Cíclico/fisiologia , Etanol/farmacologia , Regeneração Nervosa/efeitos dos fármacos , Inibidores de Adenilil Ciclases/uso terapêutico , Adenilil Ciclases/metabolismo , Transtorno Amnésico Alcoólico/metabolismo , Transtorno Amnésico Alcoólico/patologia , Transtorno Amnésico Alcoólico/terapia , Animais , Diferenciação Celular/efeitos dos fármacos , Células Cultivadas , AMP Cíclico/metabolismo , Proteínas Quinases Dependentes de AMP Cíclico/metabolismo , Camundongos , Camundongos Endogâmicos C57BL , Terapia de Alvo Molecular , Regeneração Nervosa/fisiologia , Tecido Nervoso/efeitos dos fármacos , Tecido Nervoso/fisiologia , Células-Tronco Neurais/efeitos dos fármacos , Células-Tronco Neurais/fisiologia , Doenças Neurodegenerativas/induzido quimicamente , Fármacos Neuroprotetores/farmacologia , Fármacos Neuroprotetores/uso terapêutico , Transdução de Sinais/efeitos dos fármacos , Transdução de Sinais/fisiologia
7.
Exp Brain Res ; 236(7): 1861-1868, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29680910

RESUMO

The present study focused on interference in a group of patients with amnesia due to Korsakoff's syndrome (KS) within the domain of spatial memory. An object-location memory task was used in which participants first learned an array of objects on a computer screen, followed by a reconstruction of the object positions. Next a trial was given in which the same objects were presented only now in different locations. Participants had to place the objects a second time but at the new locations. This was repeated for seven pairs of baseline/interference trials. Both Korsakoff patients and matched controls did worse on the interference trials than on the baseline trials, indicating that it is difficult to relearn new spatial locations for objects that previously were remembered in other locations. When computing relative interference effects (that is the percentage change from baseline in the interference trials), Korsakoff patients were less affected than controls. It is discussed in how far interference depends on the strength of the original memories, which are markedly lower in KS patients.


Assuntos
Transtorno Amnésico Alcoólico/fisiopatologia , Percepção Espacial/fisiologia , Memória Espacial/fisiologia , Adulto , Análise de Variância , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Aprendizagem Verbal
8.
Zh Nevrol Psikhiatr Im S S Korsakova ; 118(1. Vyp. 2): 52-59, 2018.
Artigo em Russo | MEDLINE | ID: mdl-29658505

RESUMO

AIM: To evaluate the efficacy of non-invasive multichannel electrical stimulation (sympathetic correction) in patients with alcohol amnesic (Korsakoff's) psychosis. MATERIAL AND METHODS: Thirty-seven men, aged 33-48 years, with Korsakoff's (amnestic) psychosis were studied. The duration of disease varied from 12 to 24 month. The device of electrical stimulation of neck nerve structures was used for neuroelectrostimulation. Treatment included 15 sessions within 3 weeks. During this period, patients did not receive pharmacological therapy. The Frontal Assessment Battery (FAB), the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE) were used to determine changes in cognitive state of patients. Electroencephalography with qEEG analysis and spectral analysis of heart rate variability (HRV) were carried out as well. RESULTS AND CONCLUSION: Positive effects of treatment were observed in all patients that suggested the high therapeutic potential of the neuroelectrostimulation method.


Assuntos
Transtorno Amnésico Alcoólico , Terapia por Estimulação Elétrica , Síndrome de Korsakoff , Transtornos Psicóticos , Adulto , Transtorno Amnésico Alcoólico/terapia , Eletroencefalografia , Humanos , Síndrome de Korsakoff/terapia , Masculino , Pessoa de Meia-Idade
9.
Am J Drug Alcohol Abuse ; 44(1): 129-139, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-28032801

RESUMO

BACKGROUND: Alcohol-related blackouts are a common consequence of heavy drinking, and these blackouts pose risk for injury and other adverse health outcomes. OBJECTIVE: To examine the prevalence and correlates of blackouts among underage drinkers. METHODS: Youth (ages 14-20) presenting to a suburban Emergency Department (ED) completed screening surveys. Among those reporting past-year alcohol consumption, we examined past 3-month blackouts in relation to: background characteristics (e.g., demographics, fraternity/sorority involvement), substance use, sexual risk behaviors and incapacitated sexual assault (unaware/unable to consent due to alcohol/drugs), forced sexual assault, positive depression screening, and reason for ED visit (injury vs. medical). RESULTS: In total, 2,300 past-year drinkers participated: 58% female, 75% Caucasian, and mean age = 18.4. Regarding past 3-month blackouts, 72.7% reported none, 19.3% reported monthly or less, and 8% reported monthly or more. Multivariate cumulative logit regression indicated that blackout frequency was positively associated with: college involvement in Greek life, alcohol use severity, prescription drug misuse, marijuana, screening positive for depression, incapacitated sexual assault, and a gender by alcohol use severity interaction. CONCLUSION: With one-quarter of this clinical sample reporting recent blackouts, as well as the association between blackout frequency and health risk behaviors and other outcomes, findings underscore the need for programs focusing on substance use, depression, and preventing sexual assault. Interventions should also address poly-substance use and drinking motives. Although findings highlight how college students in Greek life may be at high risk for blackouts, many participants not in college also reported blackouts, suggesting that interventions in other settings are also needed.


Assuntos
Transtorno Amnésico Alcoólico/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Consumo de Álcool por Menores/estatística & dados numéricos , Adolescente , Depressão/epidemiologia , Feminino , Humanos , Masculino , Michigan/epidemiologia , Fatores de Risco , Delitos Sexuais/estatística & dados numéricos , Adulto Jovem
10.
Rev. medica electron ; 39(supl.1): 772-780, 2017.
Artigo em Espanhol | LILACS, CUMED | ID: biblio-902256

RESUMO

La psicosis de Korsakoff (PK) es una de las causas más frecuentes de amnesia. Se caracteriza por confusión mental, deterioro de la memoria reciente y confabulación. Se presenta el caso de un paciente masculino de 53 años de edad, fumador de un paquete al día, durante más de 35 años, bebedor de riesgo, con antecedentes de hipertensión arterial e hipercolesterolemia. Se diagnosticó como psicosis de Korsakoff debido al déficit de tiamina o vitamina B1. La psicosis de Korsakoff es un síndrome amnésico que puede presentarse precedido o no de encefalopatía de Wernicke (EW), por lo que se diagnostican menos casos de los que en realidad existen. Por ello, es un problema frecuentemente infradiagnosticado en los centros de salud lo que resulta interesante el conocimiento de esta patología (AU).


Korsakoff psychosis is one of the most frequent causes of amnesia. It is characterized by mental confusion, impairment of the recent memory and confabulation. It is presented the case of a male patient, aged 53 years, who smoked 1 packet of cigarettes a day during more than 35 years, risk drinker with antecedents of arterial hypertension and hypercholesterolemia. He was diagnosed as Korsakoff psychosis due to the thiamine or B1 vitamin deficit. Korsakoff psychosis is an amnesic syndrome that may be preceded or not by Wernicke encephalopathy, so there are diagnosed fewer cases than those truly existing. That is why it is a problem frequently underdiagnosed in health care institutions, making interesting this disease´s knowledge (AU).


Assuntos
Humanos , Masculino , Feminino , Encefalopatia de Wernicke/epidemiologia , Síndrome de Korsakoff/epidemiologia , Encefalopatia de Wernicke/diagnóstico , Síndrome de Korsakoff/complicações , Síndrome de Korsakoff/diagnóstico , Síndrome de Korsakoff/genética , Síndrome de Korsakoff/patologia , Transtorno Amnésico Alcoólico/diagnóstico , Transtorno Amnésico Alcoólico/reabilitação , Transtorno Amnésico Alcoólico/epidemiologia , Doenças do Sistema Nervoso/diagnóstico , Doenças do Sistema Nervoso/epidemiologia
11.
Nurs Times ; 112(26): 22-5, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27544960

RESUMO

While dementia is an umbrella term for a range of degenerative brain disorders, many share similar presentations. Nurses are ideally placed to identify those at risk and empower them to access treatment and plan and prepare for their future needs--as such, they need up-to-date knowledge of the signs and symptoms of the different types of dementia to identify risk factors and make an informed diagnosis. This article, the third in a four-part series on dementia, examines the risk factors, signs, symptoms and diagnosis of dementia, as well as outlining lifestyle factors such as diet and exercise that may help to prevent the development of the condition.


Assuntos
Demência/prevenção & controle , Exercício Físico , Comportamento Alimentar , Abandono do Hábito de Fumar , Transtorno Amnésico Alcoólico/diagnóstico , Transtorno Amnésico Alcoólico/prevenção & controle , Doença de Alzheimer/diagnóstico , Doença de Alzheimer/prevenção & controle , Demência/diagnóstico , Demência Vascular/diagnóstico , Demência Vascular/prevenção & controle , Diagnóstico Precoce , Escolaridade , Humanos , Fatores de Risco , Comportamento de Redução do Risco
12.
Clin Neuropsychol ; 30(2): 351-66, 2016 02.
Artigo em Inglês | MEDLINE | ID: mdl-26928513

RESUMO

OBJECTIVE: Remembering the past and imaging the future are both manifestations of 'mental time travel'. These processes have been found to be impaired in patients with bilateral hippocampal lesions. Here, we examined the question of whether future thinking is affected by other Papez circuit lesions, namely: damage to the mammillary bodies/fornix. METHOD: Case (SL) was a 43-year-old woman who developed dense anterograde and retrograde amnesia suddenly, as a result of Wernicke-Korsakoff's syndrome. A region of interest volumetric Magnetic resonance imaging (MRI) analysis was performed. We assessed past and future thinking in SL and 11 control subjects of similar age and education with the adapted Autobiographical Interview (AI). Participants also completed a battery of neuropsychological tests. RESULTS: Volumetric MRI analyses revealed severely reduced fornix and mammillary body volumes, but intact hippocampi. SL showed substantial, albeit temporally graded retrograde memory deficits on the adapted AI. Strikingly, whilst SL could not provide any specific details of events from the past two weeks or past two years and had impaired recall of events from her late 30s, her descriptions of potential future events were normal in number of event details and plausibility. CONCLUSIONS: This dissociation of past and future events' performance after mammillary body and fornix damage is at odds with the findings of the majority of patients with adult onset hippocampal amnesia. It suggests that these non-hippocampal regions of the Papez circuit are only critical for past event retrieval and not for the generation of possible future events.


Assuntos
Transtorno Amnésico Alcoólico/diagnóstico por imagem , Transtorno Amnésico Alcoólico/psicologia , Dano Encefálico Crônico/diagnóstico por imagem , Dano Encefálico Crônico/psicologia , Fórnice/diagnóstico por imagem , Imaginação , Corpos Mamilares/diagnóstico por imagem , Adulto , Amnésia/psicologia , Amnésia Retrógrada , Feminino , Hipocampo/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Memória , Transtornos da Memória , Testes Neuropsicológicos , Tempo
13.
Adicciones (Palma de Mallorca) ; 28(3): 136-143, 2016. tab
Artigo em Espanhol | IBECS | ID: ibc-153927

RESUMO

Objetivo: se pretende investigar la capacidad de predicción del inventario de temperamento y carácter de Cloninger (TCI-R) en la evolución de los trastornos por uso de alcohol. Metodología: Es un estudio longitudinal de 237 pacientes con trastornos por uso de alcohol, en tratamiento ambulatorio y seguimiento durante seis meses, cuya personalidad fue estudiada mediante el inventario TCI-R. Se analizó la puntuación de cada una de las dimensiones del inventario TCI-R en función de su situación (retención o abandono) al final del estudio. Resultados: La muestra presentaba puntuaciones elevadas en búsqueda de novedad (BN) y evitación del daño (ED) y baja en autodirección (AD), definidas, estas últimas, como prominentes. El grupo que abandonó presentaba una puntuación significativamente (p= .004) más elevada en búsqueda de novedad (BN) que el grupo en seguimiento; además cuando la puntuación era superior al percentil 67 la probabilidad de abandonar era 1,07 veces superior. Conclusiones: El inventario de temperamento y carácter de Cloninger (TCI-R) es un buen instrumento para predecir la evolución de los pacientes con trastorno por uso de alcohol y la dimensión búsqueda de novedad (BN) está fuertemente relacionada con el abandono terapéutico


Objective: to investigate the ability to predict the outcome of alcohol use disorders through Cloninger’s temperament and character inventory (TCI-R). Methods: this is a prospective study consisting of 237 outpatients with alcohol use disorders who underwent follow-up treatment for 6 months and whose personality traits were studied using TCI-R. At the end of that period, the scores of each TCI-R trait were analyzed in terms of those who remained in treatment and those who dropped out. Results: The whole group scored highly in novelty seeking (NS) and harm avoidance (HA) and produced low scores in self-directedness (SD), these last traits are considered prominent. The drop-out group scored significantly (p=.004) higher in novelty seeking (NS) than the follow-up group. Also, when the score was higher than the 67 percentile the likelihood of abandoning the treatment was 1.07 times higher. Conclusions: Cloninger’s temperament and character inventory is a good instrument to predict the outcome of treatment of patients with alcohol use disorders and the novelty seeking (NS) dimension is strongly related to therapeutic drop-out


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Alcoolismo/complicações , Alcoolismo/diagnóstico , Alcoolismo/psicologia , Inventário de Personalidade/estatística & dados numéricos , Comportamento Exploratório/fisiologia , Transtornos Relacionados ao Uso de Álcool/complicações , Transtornos Relacionados ao Uso de Álcool/diagnóstico , Transtornos Relacionados ao Uso de Álcool/psicologia , Estudos Longitudinais , Comportamento Exploratório , Transtorno Amnésico Alcoólico/complicações , Transtorno Amnésico Alcoólico/psicologia , Temperamento , Inquéritos e Questionários
14.
Transl Psychiatry ; 5: e645, 2015 Sep 22.
Artigo em Inglês | MEDLINE | ID: mdl-26393491

RESUMO

The transient period of memory instability that can be triggered when memories are retrieved under certain conditions offers an opportunity to modify the maladaptive memories at the heart of substance use disorders (SUDs). However, very well-learned memories (such as those in excessive drinking and alcohol use disorders) are resistant to destabilisation when retrieved or may not destabilise at all. Memory retrieval and intervention procedures that reliably destabilise and update maladaptive motivational memories may help to improve the long-term treatment of SUDs. In 59 hazardous drinkers, we tested a novel retrieval procedure for destabilising well-learned cue-drinking memory networks that maximises prediction error (PE) via guided expectancy violation during retrieval of these memories. This was compared with a retrieval procedure without PE and no-retrieval controls. We subsequently counterconditioned alcohol cues with disgusting tastes and images in all groups and assessed responding to alcohol stimuli 1 week later. Counterconditioning following PE retrieval produced generalised reductions in oculomotor attentional bias, explicit valuation and outcome expectancies in response to alcohol cues 1 week after intervention, evidence of updating of distributed motivational drinking memory networks. These findings demonstrate that well-learned cue-drinking memories can be destabilised and that learning history need not constrain memory destabilisation if PE is maximised at retrieval. Broad rewriting of diverse aspects of maladaptive memory by counterconditioning is achievable following this procedure. The procedure described may provide a platform for the development of novel memory-modifying interventions for SUDs.


Assuntos
Transtorno Amnésico Alcoólico , Consumo de Bebidas Alcoólicas , Adolescente , Adulto , Transtorno Amnésico Alcoólico/fisiopatologia , Transtorno Amnésico Alcoólico/psicologia , Transtorno Amnésico Alcoólico/terapia , Consumo de Bebidas Alcoólicas/fisiopatologia , Consumo de Bebidas Alcoólicas/psicologia , Sinais (Psicologia) , Retroalimentação Fisiológica , Humanos , Masculino , Consolidação da Memória , Transtornos da Memória/etiologia , Transtornos da Memória/fisiopatologia , Transtornos da Memória/psicologia , Rememoração Mental/fisiologia , Motivação/fisiologia , Neuropsicologia/métodos , Técnicas Psicológicas , Reprodutibilidade dos Testes , Reversão de Aprendizagem/fisiologia
16.
Neurosci Biobehav Rev ; 54: 38-45, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25108034

RESUMO

Two brain networks are particularly affected by the harmful effect of chronic and excessive alcohol consumption: the circuit of Papez and the frontocerebellar circuit, in both of which the thalamus plays a key role. Shrinkage of the thalamus is more severe in alcoholics with Korsakoff's syndrome (KS) than in those without neurological complication (AL). In accordance with the gradient effect of thalamic abnormalities between AL and KS, the pattern of brain dysfunction in the Papez's circuit results in anterograde amnesia in KS and only mild-to-moderate episodic memory disorders in AL. On the opposite, dysfunction of the frontocerebellar circuit results in a similar pattern of working memory and executive deficits in the AL and KS. Several hypotheses, mutually compatible, can be drawn to explain that the severe thalamic shrinkage observed in KS has different consequences in the neuropsychological profile associated with the two brain networks.


Assuntos
Transtorno Amnésico Alcoólico/patologia , Alcoolismo/patologia , Memória/fisiologia , Tálamo/patologia , Tálamo/fisiopatologia , Transtorno Amnésico Alcoólico/fisiopatologia , Alcoolismo/fisiopatologia , Animais , Cerebelo/patologia , Cerebelo/fisiopatologia , Lobo Frontal/patologia , Lobo Frontal/fisiopatologia , Giro do Cíngulo/patologia , Giro do Cíngulo/fisiopatologia , Hipocampo/patologia , Hipocampo/fisiopatologia , Humanos , Corpos Mamilares/patologia , Corpos Mamilares/fisiopatologia , Rede Nervosa/patologia , Rede Nervosa/fisiopatologia , Vias Neurais/patologia , Vias Neurais/fisiopatologia
17.
Neurosci Biobehav Rev ; 54: 46-56, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25218758

RESUMO

In this review, the clinical, neuropsychological, and neuroimaging findings in the alcoholic Korsakoff syndrome and in thalamic amnesia, resulting from focal infarction, are compared. In both disorders, there is controversy over what is the critical site for anterograde amnesia to occur-damage to the anterior thalamus/mammillo-thalamic tract has most commonly been cited, but damage to the medio-dorsal nuclei has also been advocated. Both syndromes show 'core' features of an anterograde amnesic syndrome; but retrograde amnesia is generally much more extensive (going back many years or decades) in the Korsakoff syndrome. Likewise, spontaneous confabulation occurs more commonly in the Korsakoff syndrome, although seen in only a minority of chronic cases. These differences are attributed to the greater prevalence of frontal atrophy and frontal damage in Korsakoff cases.


Assuntos
Transtorno Amnésico Alcoólico/patologia , Amnésia Anterógrada/patologia , Amnésia Retrógrada/patologia , Infarto Encefálico/patologia , Tálamo/patologia , Transtorno Amnésico Alcoólico/complicações , Amnésia Anterógrada/etiologia , Amnésia Retrógrada/etiologia , Infarto Encefálico/complicações , Confusão/etiologia , Confusão/patologia , Humanos
18.
Handb Clin Neurol ; 125: 211-25, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25307577

RESUMO

Initially, alcohol-related memory deficits were considered only through the prism of Korsakoff's syndrome (KS). It is now clear, however, that chronic alcohol consumption results in memory disorders in alcoholics without ostensible neurologic complications, such as Wernicke's encephalopathy and KS. Most of the principal memory components are affected, including working memory, episodic memory, semantic memory, perceptual memory, and procedural memory. The extent of those cognitive impairments depends on several factors, such as age, gender, nutritional status, and psychiatric comorbidity. While memory disorders, especially episodic memory deficits, are largely definitive in patients with KS, recovery of memory abilities has been described with abstinence in uncomplicated alcoholics. Neuropsychologic impairments, and especially memory disorders, must be evaluated at alcohol treatment entry because they could impede patients from benefiting fully from cognitive and behavioral treatment approaches for alcohol dependence. Screening of memory deficits could also enable clinicians to detect, among alcoholics without ostensible neurologic complications, those at risk of developing permanent and debilitating amnesia that features KS.


Assuntos
Alcoolismo/diagnóstico , Encéfalo/patologia , Transtornos da Memória/diagnóstico , Rede Nervosa/patologia , Transtorno Amnésico Alcoólico/diagnóstico , Transtorno Amnésico Alcoólico/metabolismo , Transtorno Amnésico Alcoólico/psicologia , Alcoolismo/metabolismo , Alcoolismo/psicologia , Animais , Encéfalo/metabolismo , Humanos , Memória/fisiologia , Transtornos da Memória/metabolismo , Transtornos da Memória/psicologia , Rede Nervosa/metabolismo , Encefalopatia de Wernicke/diagnóstico , Encefalopatia de Wernicke/metabolismo , Encefalopatia de Wernicke/psicologia
19.
Emerg Med Clin North Am ; 32(2): 293-301, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24766933

RESUMO

Ethanol intoxication and ethanol use are associated with a variety of metabolic derangements encountered in the Emergency Department. In this article, the authors discuss alcohol intoxication and its treatment, dispel the myth that alcohol intoxication is associated with hypoglycemia, comment on electrolyte derangements and their management, review alcoholic ketoacidosis, and end with a section on alcoholic encephalopathy.


Assuntos
Acidose/etiologia , Intoxicação Alcoólica , Emergências , Hipoglicemia/etiologia , Acidose/epidemiologia , Acidose/terapia , Transtorno Amnésico Alcoólico/epidemiologia , Transtorno Amnésico Alcoólico/etiologia , Transtorno Amnésico Alcoólico/metabolismo , Intoxicação Alcoólica/complicações , Intoxicação Alcoólica/epidemiologia , Intoxicação Alcoólica/metabolismo , Saúde Global , Humanos , Hipoglicemia/epidemiologia , Hipoglicemia/terapia , Incidência , Fatores de Risco , Taxa de Sobrevida/tendências
20.
Alcohol Alcohol ; 49(3): 238-50, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24627570

RESUMO

Historical and clinical aspects of pellagra and its relationship to alcoholism are reviewed from a biochemical perspective. Pellagra is caused by deficiency of niacin (nicotinic acid) and/or its tryptophan (Trp) precursor and is compounded by B vitamin deficiencies. Existence on maize or sorghum diets and loss of or failure to isolate niacin from them led to pellagra incidence in India, South Africa, Southern Europe in the 18th century and the USA following the civil war. Pellagra is also induced by drugs inhibiting the conversion of Trp to niacin and by conditions of gastrointestinal dysfunction. Skin photosensitivity in pellagra may be due to decreased synthesis of the Trp metabolite picolinic acid → zinc deficiency → decreased skin levels of the histidine metabolite urocanic acid and possibly also increased levels of the haem precursor 5-aminolaevulinic acid (5-ALA) and photo-reactive porphyrins. Depression in pellagra may be due to a serotonin deficiency caused by decreased Trp availability to the brain. Anxiety and other neurological disturbances may be caused by 5-ALA and the Trp metabolite kynurenic acid. Pellagra symptoms are resolved by niacin, but aggravated mainly by vitamin B6. Alcohol dependence can induce or aggravate pellagra by inducing malnutrition, gastrointestinal disturbances and B vitamin deficiencies, inhibiting the conversion of Trp to niacin and promoting the accumulation of 5-ALA and porphyrins. Alcoholic pellagra encephalopathy should be managed with niacin, other B vitamins and adequate protein nutrition. Future studies should explore the potential role of 5-ALA and also KA in the skin and neurological disturbances in pellagra.


Assuntos
Alcoolismo/metabolismo , Pelagra/metabolismo , Transtorno Amnésico Alcoólico/tratamento farmacológico , Alcoolismo/complicações , Animais , Humanos , Fígado/metabolismo , Pelagra/complicações , Pelagra/etiologia , Triptofano/metabolismo , Complexo Vitamínico B/efeitos adversos , Complexo Vitamínico B/uso terapêutico
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