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Wernicke-Korsakoff Syndrome (WKS) is a neurological disorder that is caused by a deficiency in the B vitamin thiamine. Thiamine (vitamin B1) affects the brain and nervous system. Specifically, thiamine plays a critical role in metabolizing glucose to produce energy for the brain, particularly the hypothalamus. It is the hypothalamus that is regulates temperature, growth, appetite and is important in the regulation of emotional responses. It also controls pituitary functions such as metabolism, hormones and mammilary bodies where neural pathways connect various parts of the brain involved in memory.
Pathologically, intense brain changes are found in the periventricular gray matter surrounding the third and fourth ventricles of the brain, the mammilary bodies, the aqueduct of Sylvius, and the dorsomedial nuclei of the thalamus. These areas show a loss of neurons, moderate vascular proliferation and the mammilary bodies are often shrunken and discolored.
The basis of amnesia in alcoholic Wernicke-Korsakoff syndrome (WKS) has been generally associated with diencephalic lesions and more specifically with lesions of the anterior thalamic nuclei. These brain structures are considered to be involved in encoding/consolidation processes of episodic memory. However, frontal lobe damage responsible for executive function deficits has also been documented.
Chronic and heavy alcohol abuse is often the most common cause of thiamine deficiency and the subsequent development of WKS. This is related to the fact that many heavy drinkers eat poorly and thereby do not consume a diet that contains essential vitamins. Further, alcohol can often inflame the stomach lining and thereby impede the body's natural ability to absorb key vitamins. Other causes of dietary deficiencies and gastrointestinal absorption problems leading to WKS can include carcinoma of the esophagus or stomach, excessive vomiting, gastric surgery and prolonged diarrhea.