Peter Martin Historical Vocabulary of Addiction
Peter Martin’s response to Hector Warnes’ reply to his comment
This insightful comment by Hector Warnes demonstrates the wealth of his clinical experience and his translational thinking. He identifies one of the most important issues in the pathogenesis of Wernicke-Korsakoff syndrome — the interindividual differences in susceptibility to the disorder among individuals who are exposed to alcoholism and malnutrition. Why do only a fraction of those with Wernicke’s encephalopathy progress to Korsakoff’s psychosis? This enigma remains to be answered yet.
We have proposed to explain interindividual differences in susceptibility to brain injury in alcoholics based on various aspects of thiamine metabolism (Martin, Singleton and Hiller-Sturmhöfel 2003), although it seems that other issues may also be relevant as Warnes points out, especially comorbid medical illnesses such as liver disease, head trauma, and premorbid brain functioning among many other factors.
Additionally, I would like to emphasize that Korsakoff’s Psychosis is quite distinct from dementia in its clinical presentation and neuropsychological characteristics and has been so classified in most diagnostic systems. For example, patients with Korsakoff’s Psychosis can be demonstrated to have a different structure of neuropsychological deficits compared to those diagnosed with Alzheimer’s disease (Weingartner, Grafman, Boutelle et al. 1983).
Martin PR, Singleton CK, Hiller-Sturmhöfel S. The role of thiamine deficiency in alcoholic brain disease. Alcohol Res Health 2003;27(2):134–42.
Weingartner H, Grafman J, Boutelle W, Kaye W, Martin PR. Forms of memory failure. Science 1983;221(4608):380-2.
April 21, 2022