SEPARATING COGNITIVE IMPAIRMENT IN NEUROLOGICALLY ASYMPTOMATIC ALCOHOLISM FROM WERNICKE-KORSAKOFF-SYNDROME - IS THE NEUROPSYCHOLOGICAL DISTINCTION JUSTIFIED
SEPARATING COGNITIVE IMPAIRMENT IN NEUROLOGICALLY ASYMPTOMATIC ALCOHOLISM FROM WERNICKE-KORSAKOFF-SYNDROME - IS THE NEUROPSYCHOLOGICAL DISTINCTION JUSTIFIED
复制标题
DOI：
10.1037/0033-2909.107.3.355
复制
发表时间：
1990-05-01
影响因子：
22.4
通讯作者：
BOWDEN, SC
中科院分区：
文献类型：
--
作者：
BOWDEN, SC
最近的研究，结合神经病理学数据和临床病史的回顾性方式表明，Wernicke-Korsakoff神经病理学往往是未被怀疑的死前，在临床表现方面，它是更异质性比以前假设的。因此，许多神经系统正常的酗酒者的研究可能会被纳入神经系统无症状的Wernicke-Korsakoff神经病理学患者混淆。尸检和体内研究表明，酗酒者，无论神经学诊断，有广泛的病理涉及许多皮质和皮质下的网站。此外，临床研究表明，与神经学上无症状的酗酒者一样，酒精性科尔萨科夫患者的认知功能可能会大幅恢复。此外，通过使用定义性IQ-韦氏记忆量表商数差异将神经学诊断的Wernicke-Korsakoff综合征的子集识别为“纯”Korsakoff遗忘症的离散组的常见研究策略可能产生了一种神经心理学刻板印象，其不代表更广泛的临床组。鉴于这些考虑，对以Wernicke-Korsakoff综合征临床体征区分的酗酒者群体进行认知障碍的单独治疗可能是不合理的。
Recent studies that have combined neuropathological data and clinical histories in a retrospective fashion have shown that Wernicke-Korsakoff neuropathology is often unsuspected antemortem and that, in terms of clinical presentation, it is more heterogeneous than previously assumed. Thus, many studies of neurologically normal alcoholics may have been confounded by the inclusion of patients with neurologically asymptomatic Wernicke-Korsakoff neuropathology. Postmortem and in vivo studies have shown that alcoholics, irrespective of neurological diagnosis, have widespread pathology involving many cortical and subcortical sites. In addition, clinical studies have indicated that, like neurologically asymptomatic alcoholics, alcoholic Korsakoff patients may enjoy substantial recovery in cognitive function. Furthermore, the common research strategy of identifying a subset of neurologically diagnosed Wernicke-Korsakoff syndrome as a discrete group of “pure” Korsakoff's amnesia by using a definitional IQ–Wechsler Memory Scale quotient difference may have created a neuropsychological stereotype that is not representative of the broader clinical group. In light of these considerations, the separate treatment of cognitive impairment in groups of alcoholics distinguished by the clinical signs of Wernicke-Korsakoff syndrome may not be justified.