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Oosterman JM, de Goede M, Wester AJ, van Zandvoort MJE, Kessels RPC. Perspective taking in Korsakoff's syndrome: the role of executive functioning and task complexity.
Objective: The ability to make inferences about knowledge, thoughts and feelings of others, i.e. perspective taking, is a key element of social cognition. Clinical observations indicate that Korsakoff patients may have impairments in social cognition, but studies are scarce. Also, executive dysfunction is present in Korsakoff patients, which may hamper perspective taking directly.
Methods: Twenty-three patients with Korsakoff's syndrome and 15 healthy matched controls were examined on a story comprehension task, in which inferences had to be made that either relied on perspective taking or not. The effects of task complexity were taken into account and executive function was assessed using an extensive neuropsychological test battery.
Results: The performance of Korsakoff patients declined with increasing complexity, but the pattern of decline for perspective-taking and non-perspective-taking stories was similar compared to that of the control group. Furthermore, the performance decline with increasing task complexity was directly related to the overall decline in executive functioning.
Conclusion: Executive dysfunction, not deficits in perspective taking per se, appears to underlie difficulties in story comprehension in patients with Korsakoff's syndrome.
This article describes an exploratory study of MMPI-2 administration to 20 patients with Korsakoff's disease, all admitted to the Korsakoff unit of a major psychiatric hospital in the Netherlands.
We compared their MMPI-2 basic profiles with those of an inpatient alcohol-dependent non-Korsakoff group. Attention was also given to content scales and some selected supplementary scales. Furthermore, we explored the differences between MMPI-2 profiles of Korsakoff patients with and without insight into oneself and one's disease.
Compared with both the Dutch norms and the scale means of the non-Korsakoff alcoholics, Korsakoff patients showed an extraordinary flat profile. Illness insight appeared to be related to the levels of the various scales.
The results show the potential usefulness of the MMPI-2 in the differential diagnosis of chronic alcoholism and Korsakoff's disease.
Objectives: Neuropsychological assessment of memory disorders is an important prerequisite in the treatment of patients with alcohol-related cognitive disorders. Although many memory tests are available in clinical practice, a question remains regarding which test is most appropriate for this purpose. Our study's goal was to evaluate the discriminative power of indices of a standard memory test (the California Verbal Learning Test; CVLT) versus the subtests of an ecologically valid everyday memory test (the Rivermead Behavioural Memory Test; RBMT) in patients with alcohol-use disorder.
Method: The patients included 136 with Korsakoff's syndrome (KS), 73 alcoholics with cognitive impairment (CI) not fulfilling the criteria for KS, and 24 cognitively unimpaired alcoholics (ALC).
Results: KS patients performed significantly lower on all RBMT and CVLT variables than CI patients. ALC patients performed significantly better than CI patients on only one RBMT subtest, and had a significantly lower rate of forgetting and higher scores on free recall on CVLT. A combination of RBMT subtests and CVLT indices was able to discriminate KS patients from CI and ALC patients. The RBMT subtests could not significantly distinguish ALC from CI patients. Both rate of forgetting and a comparison between free and cued recall testing on the CVLT showed the largest between-group differences.
Conclusion: Although the RBMT provides information about everyday memory performance, the CVLT indices are better able to distinguish between uncomplicated alcoholics and those with cognitive impairment or KS.
This study directly compared how well Korsakoff patients can process
spatial and temporal order information in memory under conditions that
included presentation of only a single feature (i.e., temporal or spatial
information), combined spatiotemporal presentation, and combined
spatiotemporal order recall. Korsakoff patients were found to suffer
comparable spatial and temporal order recall deficits. Of interest, recall
of a single feature was the same when only spatial or temporal information
was presented compared to conditions that included combined spatiotemporal
presentation and recall. In contrast, control participants performed worse
when they have to recall both spatial and temporal order compared to when
they have to recall only one of these features. These findings together
indicate that spatial and temporal information are not automatically
integrated. Korsakoff patients have profound problems in coding the
feature at hand. Moreover, their lower recall of both features at the same
time suggests that Korsakoff patients are impaired in binding different
contextual attributes together in memory. (JINS, 2006,
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