Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-11-19T04:56:51.922Z Has data issue: false hasContentIssue false

Korsakoff's syndrome, cognition and clonidine

Published online by Cambridge University Press:  09 July 2009

R. E. O'Carroll*
Affiliation:
MRC Brain Metabolism Unit, Edinburgh
A. Moffoot
Affiliation:
MRC Brain Metabolism Unit, Edinburgh
K. P. Ebmeier
Affiliation:
MRC Brain Metabolism Unit, Edinburgh
C. Murray
Affiliation:
MRC Brain Metabolism Unit, Edinburgh
G. M. Goodwin
Affiliation:
MRC Brain Metabolism Unit, Edinburgh
*
1Address for correspondence: Dr R. E. O'Carroll, MRC Brain Metabolism Unit, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF.

Synopsis

Eighteen patients suffering from Alcoholic Korsakoff's Syndrome participated in a placebo-controlled double-blind cross-over trial of clonidine 0·3 mg b.d. for two weeks versus matched placebo for two weeks. A detailed neuropsychological assessment was carried out at the end of each treatment phase and staff ratings of behaviour were also obtained. Clonidine treatment resulted in no significant improvement over placebo on any of the cognitive measures employed. The results contradict previous smaller studies which had suggested that chronic treatment with clonidine had a memory-enhancing effect in Korsakoff's syndrome.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1993

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Arnsten, A. F. T., Cai, J. & Goldman-Rakic, P. (1988). The alpha-2 adrenergic agonist guanfacine improves memory in aged monkeys without sedative or hypotensive side effects. Journal of Neuroscience 8, 42874298.CrossRefGoogle ScholarPubMed
Arnsten, A. F. T. & Goldman-Rakic, P. S. (1985) α2-Adrenergic mechanisms in prefrontal cortex associated with cognitive decline in aged nonhuman primates. Science 230, 12731276.CrossRefGoogle Scholar
Baddeley, A. D. (1976). The Psychology of Memory. Basic Books: New York.Google Scholar
Benton, A. L. & Hamsher, K. (1978). Multilingual Aphasia Examination Manual – Revised. University of Iowa: Iowa City.Google Scholar
Bowden, S. C. (1990). Separating cognitive impairment in neurologically asymptomatic alcoholism from Wernicke-Korsakoff syndrome: is the neuropsychological distinction justified? Psychological Bulletin 3, 355366.CrossRefGoogle Scholar
Broadbent, D. E., Cooper, P. F., FitzGerald, P. & Parkes, K. R. (1982). The Cognitive Failures Questionnaire (CFQ) and its correlates. British Journal of Clinical Psychology 21, 116.CrossRefGoogle ScholarPubMed
Brozoski, T., Brown, H., Rosvold, H. & Goldman, P. S. (1979). Cognitive deficit caused by regional depletion of dopamine in prefrontal cortex of rhesus monkeys. Science 205, 929931.CrossRefGoogle Scholar
Butters, N. (1985). Alcoholic Korsakoff's Syndrome: some unresolved issues concerning etiology, neuropathology, and cognitive deficits. Journal of Clinical and Experimental Neuropsychology 7, 181210.CrossRefGoogle ScholarPubMed
Butters, N. & Cermak, L. S. (1980). Alcoholic Korsakoff's Syndrome: An Information-Processing Approach to Amnesia. Academic Press: New York.Google Scholar
Christie, J. E. (1982). Physostigmine and arecoline infusions in Alzheimer's disease. In Alzheimer's Disease: A Report of Progress (ed. Corkin, S.), pp. 413419. Raven Press: New York.Google Scholar
Christie, J. E., Shering, A., Ferguson, J. & Glen, A. I. M. (1981). Physostigmine and arecoline: effects of intravenous infusions in Alzheimer presenile dementia. British Journal of Psychiatry 138, 4650.CrossRefGoogle ScholarPubMed
Clark, C. R., Geffen, G. M. & Geffen, L. B. (1986). Role of monoamine pathways in attention and effort: effects of clonidine and methylphenidate in normal adult humans. Psychopharmacology 90, 3539.Google ScholarPubMed
Crawford, J. R., Besson, J. A. O. & Parker, D. M. (1988). Estimation of pre-morbid intelligence in organic conditions. British Journal of Psychiatry 153, 178181.CrossRefGoogle Scholar
Crawford, J. R., Stewart, L. E., Cochrane, R. H. B., Foulds, J. A., Besson, J. A. O. & Parker, D. M. (1989). Estimating premorbid IQ from demographic variables: regression equations derived from a UK sample. British Journal of Clinical Psychology 28, 275278.CrossRefGoogle ScholarPubMed
Davis, K., Mohs, R. & Tinklenberg, J. (1979). Enhancement of memory by physostigmine. New England Journal of Medicine 301, 946947.Google ScholarPubMed
Eagger, S. A., Levy, R. & Sahakian, B. J. (1991). Tacrine in Alzheimer's disease. Lancet 337, 989992.CrossRefGoogle ScholarPubMed
Frith, C. D., Dowdy, J., Ferrier, I. N. & Crow, T. J. (1985). Selective impairment of paired associate learning after administration of a centrally-acting adrenergic agonist (clonidine). Psychopharmacology 87, 490493.CrossRefGoogle ScholarPubMed
Frith, C. D., McGinty, M. A., Gergel, I. & Crow, T. J. (1989). The effects of scopolamine and clonidine upon the performance and learning of a motor skill. Psychopharmacology 98, 120125.CrossRefGoogle ScholarPubMed
Goldman-Rakic, P. & Brown, R. M. (1981). Regional changes of monoamines in cerebral cortex and subcortical structures of aging rhesus monkeys. Neuroscience 6, 177187.CrossRefGoogle ScholarPubMed
Hollander, E., Davison, M., Mohs, R. C., Horvath, T. B., Davis, B., Zemishlang, Z. & Davis, K. L. (1987). RS86 in the treatment of Alzheimer's disease – cognitive and biological effects. Biological Psychiatry 22, 10671078.CrossRefGoogle Scholar
Jacobson, R. R., Acker, C. F. & Lishman, W. A. (1990). Patterns of neuropsychological deficit in alcoholic Korsakoff's syndrome. Psychological Medicine 20, 321334.CrossRefGoogle ScholarPubMed
Joyce, E. M. & Robbins, T. W. (1991). Frontal lobe function in Korsakoff and non-Korsakoff alcoholics: planning and spatial working memory. Neuropscyhologia 29, 709723.CrossRefGoogle ScholarPubMed
Kolb, B. & Whishaw, I. Q. (1990). Fundamentals of Human Neuropsychology, 3rd edn.Freeman & Co.: New York.Google Scholar
Kopelman, M. D. (1989). Remote and autobiographical memory, temporal context memory and frontal atrophy in Korsakoff and Alzheimer patients. Neuropsychologia 27, 437460.CrossRefGoogle ScholarPubMed
Kopelman, M. D. (1991 a). Frontal dysfunction and memory deficits in the alcoholic Korsakoff syndrome and Alzheimer-type dimentia. Brain 114, 117137.Google Scholar
Kopelman, M. D. (1991 b). Non-verbal, short-term forgetting in the Alcoholic Korsakoff syndrome and Alzheimer-type dementia. Neuropsychologia 29, 737747.CrossRefGoogle ScholarPubMed
Korsakoff, S. S. (1889). Étude médico-psychologique sur une forme des maladies de la mémoire. Revue Philosophique 28, 501530.Google Scholar
Lezak, M. (1983). Neuropsychological Assessment, 2nd edn.Oxford University Press: Oxford.Google Scholar
Lishman, W. A. (1987). Organic Psychiatry. The Psychological Consequences of Cerebral Disorder, 2nd edn.Blackwell Scientific Publications: Oxford.Google Scholar
McEntee, W. J. & Mair, R. G. (1978). Memory impairment in Korsakoff's psychosis: a correlation with brain noradrenergic activity. Science 202, 905907.CrossRefGoogle ScholarPubMed
McEntee, W. J. & Mair, R. G. (1980). Memory enhancement in Korsakoff's psychosis by clonidine: further evidence for a noradrenergic deficit. Annals of Neurology 7, 466470.CrossRefGoogle ScholarPubMed
McEntee, W. J. & Mair, R. G. (1990). The Korsakoff syndrome: a neurochemical perspective. Trends in Neuroscience 13, 340344.CrossRefGoogle ScholarPubMed
McEntee, W. J., Mair, R. G. & Langlais, P. J. (1984). Neurochemical pathology in Korsakoff's psychosis: implications for other cognitive disorders. Neurology 34, 648652.CrossRefGoogle ScholarPubMed
Mair, R. G. & McEntee, W. J. (1986). Cognitive enhancement in Korsakoff's psychosis by clonidine: a comparison with L-Dopa and ephedrine. Psychopharmacology 88, 374380.CrossRefGoogle ScholarPubMed
Martin, P. R., Ebert, M. H., Gordon, E. K., Weingartner, H. & Kopin, I. J. (1984). Catecholamine metabolism during clonidine withdrawal. Psychopharmacology 84, 5863.CrossRefGoogle ScholarPubMed
Milner, B. & Petrides, N. (1984). Behavioural effects of frontal lobe lesions in man. Trends in Neurosciences 7, 403407.CrossRefGoogle Scholar
Moffoot, A., O'Carroll, R. E., Murray, C., Dougall, N., Ebmeier, K. & Goodwin, G. M. (1992). Clonidine infusion increases regional cerebral blood flow in anterior cingulate and improves verbal fluency in Korsakoff's psychosis. Submitted for publication.Google Scholar
Nelson, H. E., Pantelis, C., Carruthers, K., Speller, J., Baxendale, S. & Barnes, T. R. (1990). Cognitive functioning and symptomatology in chronic schizophrenia. Psychological Medicine 20, 357365.CrossRefGoogle ScholarPubMed
O'Carroll, R. E., Moffoot, A., Ebmeier, K. P., Murray, C. & Goodwin, G. M. (1992). Estimating pre-morbid intellectual ability in the Alcoholic Korsakoff Syndrome. Psychological Medicine 22, 903909.CrossRefGoogle ScholarPubMed
Roth, M., Tym, E., Mountjoy, C. Q., Huppert, F. A., Hendrie, H., Verma, S. & Goddard, R. (1986). CAMDEX. A standardized instrument for the diagnosis of mental disorder in the elderly with special reference to the early detection of dementia. British Journal of Psychiatry 149, 698709.CrossRefGoogle Scholar
Shallice, T. & Evans, M. (1978). The involvement of the frontal lobes in cognitive estimation. Cortex 14, 294303.CrossRefGoogle ScholarPubMed
Shoqeirat, M. A., Mayes, A., MacDonald, C., Meudell, P. & Pickering, A. (1990). Performance on tests sensitive to frontal lobe lesions by patients with organic amnesia: Leng & Parkin revisited. British Journal of Clinical Psychology 29, 401408.CrossRefGoogle ScholarPubMed
Squire, L. R., Amaral, D. G. & Press, G. A. (1990). Magnetic resonance imaging of the hippocampal formation and mammilliary nuclei distinguish medial temporal lobe and diencephalic amnesia. Journal of Neuroscience 10, 31063117.CrossRefGoogle Scholar
Thal, L., Masur, D. & Blau, A. (1989). Chronic oral physostigmine without lecithin improves memory in Alzheimer's disease. Journal of the American Geriatric Society 37, 4248.CrossRefGoogle ScholarPubMed
Victor, M., Adams, R. D. & Collins, G. H. (1989). The Wernicke–Korsakoff Syndrome and Related Neurological Disorders Due to Alcoholism and Malnutrition. F. A. Davis: Philadelphia.Google Scholar
Volger, B. W. (1991). Alternatives in the treatment of memory loss in patients with Alzheimer's disease. Clinical Pharmacology 10, 447456.Google ScholarPubMed
Wechsler, D. (1945). A standardised memory scale for clinical use. Journal of Psychology 19, 8795.CrossRefGoogle Scholar
Wechsler, D. (1981). Wechsler Adult Intelligence Scale – Revised. The Psychological Corporation: New York.Google Scholar
Wechsler, D. (1987). Wechsler Memory Scale – Revised. The Psychological Corporation. Harcourt Brace Jovanovich: New York.Google Scholar
Wernicke, C. (1881). Lehrbuch der Gehirnkrankheiten für Aerzte und Studierende. Theodor Fischer: Kassel.Google Scholar
Wilson, B., Cockburn, J. & Baddeley, A. D. (1985). Rivermead Behavioural Memory Test. Thames Valley Test Co.: Titchfield, Fareham.Google Scholar