Clinical and physiological implications and correlations.

Abstract

Cerebral dysfunction in alcoholics has important treatment implications. However, overall correlations between neuropathological impairment, neuropsychiatric performance, and clinical outcome are low and seldom reported to exceed 0.3-0.4. Three main diagnostic issues are discussed, reversibility of dementia symptoms, frontal lobe dysfunction, and the Wernicke-Korsakoff syndrome. To predict the reversibility of dementia symptoms in the individual alcoholic is important for the clinician. While routine diagnostic procedures do not give such information, a combination of brain imaging techniques and psychometric tests could be a possible development. Frontal lobe dysfunction is related to high-level cognition and general integration of behaviour. Psychometric tests give uncertain results. Inclusion of brain imaging techniques could possibly improve the diagnostic procedure. The autopsy frequency of the Wernicke-Korsakoff syndrome is much higher than the clinical diagnostic prevalence during life. This discrepancy may be related to the rarity of the classical symptoms and to overdiagnosis of non-Korsakoff alcohol dementia.