Korsakoff's syndrome (KS) is marked by global amnesia, which develops either insidiously or in the wake of Wernicke's encephalopathy and whose most common etiology is the combination of thiamine deficiency and alcoholism. In addition to severe anterograde amnesia, alcoholic Korsakoff's syndrome encompasses other neuropsychological impairments, such as executive dysfunctions, retrograde amnesia, visuospatial deficits and ataxia of gait and balance.

 Postmortem studies of alcoholic Korsakoff patients have shown pathological abnormalities involving periventricular and periaqueductal gray matter, walls of the third ventricle, floor of the fourth ventricle and cerebellum. Damage has also been found in the hippocampus certain nuclei of the thalamus hypothalamus and more particularly the mammillary bodies cerebral cortex , brainstem nuclei  and locus coeruleus . Neuroimaging studies using computerized tomography have revealed morphological abnormalities, involving cortical volume reduction, ventricular enlargement, Sylvian fissure and frontal sulcus widening, wider interhemispheric fissure and thalamic hypodensity , . More specifically, magnetic resonance imaging (MRI) has highlighted decreased volume of the parietal and frontal cortex thalamus – and mammillary bodies. Findings in the medial temporal lobe of patients with KS are more controversial, with the hippocampus being reported as either preserved or damaged.

 These previous MRI investigations, based on the region of interest (ROI) method, have provided considerable and robust insight into morphological abnormalities characterizing KS. However, because they were hypothesis-driven, they only assessed a fraction of the brain parenchyma and may have missed abnormalities in regions of the brain which were not examined. Moreover, very few in vivo studies have examined white matter in this pathology even though reductions in white matter volume have been found in neuropathological studies of KS and chronic alcoholism is known to affect white matter macrostructure and microstructure. A voxel-based (voxel-based morphometry, VBM) examination of both gray and white matter damage in KS would thus be useful for providing a comprehensive assessment of the morphological brain alterations characterizing this syndrome.

Pitel A-L, Aupée A-M, Chételat G, Mézenge F, Beaunieux H, et al. (2009) Morphological and Glucose Metabolism Abnormalities in Alcoholic Korsakoff's Syndrome: Group Comparisons and Individual Analyses. PLoS ONE 4(11): e7748. doi:10.1371/journal.pone.0007748