期刊名称：Revue de Neuropsychologie Neurosciences Cognitives et Cliniques
印刷版ISSN：2101-6739
电子版ISSN：2102-6025
出版年度：2013
卷号：5
期号：3
页码：179-186
DOI：10.1684/nrp.2013.0270
出版社：John Libbey Eurotext
摘要：Figures See all figures Authors Anne-Lise Pitel , Coralie Lannuzel , Fausto Viader , François Vabret , Francis Eustache , Hélène Beaunieux Inserm, EPHE, université de Caen/Basse-Normandie, CHU de Caen, GIP Cyceron, unité U1077, boulevard Henri-Becquerel, BP 5229, 14074 Caen cedex, France Key words: alcohol-dependence, Korsakoff's syndrome, memory systems, brain imaging DOI : 10.1684/nrp.2013.0270 Page(s) : 179-86 Published in: 2013 There is considerable heterogeneity in the alcohol-related consequences on brain structure and function. In accordance with the continuity theory proposed in 1971, there are graded effects of episodic memory deficits and brain damage in the circuit of Papez from mild-to-moderate in “uncomplicated” alcoholics to more severe in alcoholic patients with Korsakoff's syndrome. On the contrary, the working memory and executive functions, as well as the structures of the frontocerebellar circuit, are damaged to the same extent in the two groups of patients. A graded deterioration in semantic and procedural memory has also been reported in “uncomplicated” alcoholics and patients with Korsakoff's syndrome. However, such impairments may principally reflect, via indirect mechanisms, those observed for episodic memory, which is required for the encoding of new semantic and procedural information. Accordingly, the relevance of the concept of continuity seems to be limited to episodic memory and its associated circuit of Papez. The continuity theory is therefore not applicable to all memory systems and to all brain circuits. The confirmation that Papez's circuit and frontocerebellar circuits are differentially affected by chronic and excessive alcohol consumption requires further neuropsychological and neuroimaging investigations. The next step will be to compare brain metabolism and functional connectivity within those two circuits in alcoholic patients with and without Korsakoff's syndrome. From a clinical perspective, alcoholic patients with problems of episodic memory or specific deficits in brain volume of Papez's circuit similar to those of patients with Korsakoff's syndrome may be considered at risk for the development of alcohol-related neuropsychiatric complications. Thus, when used in strictly defined circumstances, the continuity theory would enable the detection, prevention and treatment of the latter patients before the development of irreversible and debilitating damage such as Korsakoff's disease.
