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The nucleus basalis (Ch4) in the alcoholic Wernicke-Korsakoff syndrome: reduced cell number in both amnesic and non-amnesic patients.
J Neurol Neurosurg Psychiatry. 1997 Sep; 63(3):315-20.JN

Abstract

BACKGROUND

The cholinergic nucleus basalis (Ch4) is an exclusive site of neurofibrillary degeneration in alcoholic patients with Wernicke's encephalopathy.

AIM

To test the hypothesis that the loss of Ch4 neurons contributes to the memory disorder, Korsakoff's psychosis, commonly seen in Wernicke's encephalopathy.

METHODS

Magnocellular basal forebrain neurons were quantified in alcoholic patients with Wernicke's encephalopathy, both with and without Korsakoff's psychosis, and neurologically asymptomatic alcoholic and non-alcoholic controls. Because amnesic and non-amnesic patients with Wernicke's encephalopathy share common periventricular lesions, both thiamine deficient groups as well as alcoholic patients with no neurological complications were included to determine the lesion specific to memory impairment.

RESULTS

Ch4 cell number did not differ significantly between alcoholic and non-alcoholic controls and there was no correlation between cell number and lifetime alcohol intake. However, Ch4 cell number in all groups was significantly correlated with the volume of its major projection target, the cerebral cortex. Ch4 cell number in the non-amnesic Wernicke's encephalopathy group was significantly below controls (24%), with cell number in patients with Korsakoff's psychosis 21% below controls. There was considerable overlap in cell number between groups. On discriminant analysis, there was significantly greater cell loss in three non-amnesic patients with Wernicke's encephalopathy than in some patients with Korsakoff's psychosis. The nonamnesic patient with the greatest cell loss was impaired on attentional tasks.

CONCLUSION

Whereas neurons in the nucleus basalis are at risk in thiamine deficient alcoholic patients, cell loss is minor and does not account for the profound memory disorder.

Authors+Show Affiliations

Department of Pathology, The University of Sydney, NSW, Australia.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

9328247

Citation

Cullen, K M., et al. "The Nucleus Basalis (Ch4) in the Alcoholic Wernicke-Korsakoff Syndrome: Reduced Cell Number in Both Amnesic and Non-amnesic Patients." Journal of Neurology, Neurosurgery, and Psychiatry, vol. 63, no. 3, 1997, pp. 315-20.
Cullen KM, Halliday GM, Caine D, et al. The nucleus basalis (Ch4) in the alcoholic Wernicke-Korsakoff syndrome: reduced cell number in both amnesic and non-amnesic patients. J Neurol Neurosurg Psychiatry. 1997;63(3):315-20.
Cullen, K. M., Halliday, G. M., Caine, D., & Kril, J. J. (1997). The nucleus basalis (Ch4) in the alcoholic Wernicke-Korsakoff syndrome: reduced cell number in both amnesic and non-amnesic patients. Journal of Neurology, Neurosurgery, and Psychiatry, 63(3), 315-20.
Cullen KM, et al. The Nucleus Basalis (Ch4) in the Alcoholic Wernicke-Korsakoff Syndrome: Reduced Cell Number in Both Amnesic and Non-amnesic Patients. J Neurol Neurosurg Psychiatry. 1997;63(3):315-20. PubMed PMID: 9328247.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The nucleus basalis (Ch4) in the alcoholic Wernicke-Korsakoff syndrome: reduced cell number in both amnesic and non-amnesic patients. AU - Cullen,K M, AU - Halliday,G M, AU - Caine,D, AU - Kril,J J, PY - 1997/11/5/pubmed PY - 1997/11/5/medline PY - 1997/11/5/entrez SP - 315 EP - 20 JF - Journal of neurology, neurosurgery, and psychiatry JO - J Neurol Neurosurg Psychiatry VL - 63 IS - 3 N2 - BACKGROUND: The cholinergic nucleus basalis (Ch4) is an exclusive site of neurofibrillary degeneration in alcoholic patients with Wernicke's encephalopathy. AIM: To test the hypothesis that the loss of Ch4 neurons contributes to the memory disorder, Korsakoff's psychosis, commonly seen in Wernicke's encephalopathy. METHODS: Magnocellular basal forebrain neurons were quantified in alcoholic patients with Wernicke's encephalopathy, both with and without Korsakoff's psychosis, and neurologically asymptomatic alcoholic and non-alcoholic controls. Because amnesic and non-amnesic patients with Wernicke's encephalopathy share common periventricular lesions, both thiamine deficient groups as well as alcoholic patients with no neurological complications were included to determine the lesion specific to memory impairment. RESULTS: Ch4 cell number did not differ significantly between alcoholic and non-alcoholic controls and there was no correlation between cell number and lifetime alcohol intake. However, Ch4 cell number in all groups was significantly correlated with the volume of its major projection target, the cerebral cortex. Ch4 cell number in the non-amnesic Wernicke's encephalopathy group was significantly below controls (24%), with cell number in patients with Korsakoff's psychosis 21% below controls. There was considerable overlap in cell number between groups. On discriminant analysis, there was significantly greater cell loss in three non-amnesic patients with Wernicke's encephalopathy than in some patients with Korsakoff's psychosis. The nonamnesic patient with the greatest cell loss was impaired on attentional tasks. CONCLUSION: Whereas neurons in the nucleus basalis are at risk in thiamine deficient alcoholic patients, cell loss is minor and does not account for the profound memory disorder. SN - 0022-3050 UR - https://www.unboundmedicine.com/medline/citation/9328247/The_nucleus_basalis__Ch4__in_the_alcoholic_Wernicke_Korsakoff_syndrome:_reduced_cell_number_in_both_amnesic_and_non_amnesic_patients_ L2 - https://jnnp.bmj.com/lookup/pmidlookup?view=long&pmid=9328247 DB - PRIME DP - Unbound Medicine ER -