Diseases of Memory – Alzheimer’s Disease - Possible Causes
Aging increases mutations.
Genes, but only 4-8% is genetic.
Brain damage.
Inflammation.
Current Treatments:
Cholinesterase inhibitors – increase Ach.
NMDA antagonists – reduce glutamate (Glutamate is important for memory but prevents).
Cognitive and physical exercise.
Immunotherapies against amyloid plaques.
"A Man Who Mistook His Wife for a Hat" – Oliver Sacks
Diseases of Memory – Korsakoff’s Syndrome
Sergei Korsakoff (1889)
Patients converse normally.
Retain old memories.
Severe anterograde amnesia.
Display wild confabulation (tales).
The Korsakoff’s brain:
Degeneration of the Mammillary bodies.
Lesions of the thalamic nuclei (Thalamus -rehearsal circuit – consolidation issue).
Living in a segmented world where every 2-3 minutes their memory resets.
Alzheimer’s patients have retrograde amnesia, but Korsakoff’s patients don’t, which is why they come up with situations to try to make sense of their new circumstances.
Korsakoff’s syndrome results from thiamine (vitamin B1) deficiency.
KS is often seen in alcoholics:
Alcohol replaces calories, leading to less B1.
High proof alcohol reduces B1 absorption.
Prevention in alcoholics:
Australia is adding thiamine to their alcohol.
Adding thiamine to bread.
One other way to get KS – in the ER
Severely malnourished adults without KS are given glucose without thiamine, causing accute KS in the patient. The glucose is used but without the thiamine, it becomes toxic