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NEUROLOGY 1984;34:648
© 1984 American Academy of Neurology

Neurochemical pathology in Korsakoff's psychosis

Implications for other cognitive disorders William J. McEntee, MD, Robert G. Mair, PhD and Philip J. Langlais, MA

From the Neurology Service, Veterans Administration Medical Center (Drs. McEntee and Mair), Division of Neurology (Dr. McEntee), and Section of Psychiatry and Human Behavior (Dr. Mair), Brown University, Providence, RI; and the Brain Tissue Resource Center (Mr. Langlais), Ralph Lowell Laboratories, McLean Hospital, Belmont. MA.

There seems to be an anatomic correspondence between pathways of monoamine-containing neurons and the brainstem and diencephalic lesions associated with Korsakoff s psychosis. In 25 patients with Korsakoff s disease, we found that CSF levels of metabolites of norepinephrine, dopamine, and serotonin were significantly lower than in controls. Norepinephrine metabolite levels were reduced more consistently and extensively than those of dopamine and serotonin. The 25 patients had circumscribed cognitive deficits, but were not demented. We argue that norepinephrinecontaining neurons are selectively damaged in Korsakoff s psychosis and that lesions of brain monoamine-containing neurons cause specific cognitive impairments, not global dementia.

Address correspondence and reprint requests to Dr. McEntee, Neurology Service, Veterans Administration Medical Center. Providence, RI 02908.

Supported by Veterans Administration research funds

Presented in part at the thirty-fourth Annual Meeting of the American Academy of Neurology, Washington, DC, May 1982.

Accepted for publication August 18, 1983.




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