Dataset Information

Distinct Sleep Alterations in Alcohol Use Disorder Patients with and without Korsakoff's Syndrome: Relationship with Episodic Memory.

ABSTRACT: Alcohol Use Disorder (AUD) results in sleep disturbances that may have deleterious impacts on cognition, especially on memory. However, little is known about the sleep architecture in patients with Korsakoff's syndrome (KS). This study aims at characterizing sleep disturbances in KS compared to AUD without KS and at specifying the relationships with cognitive impairments. Twenty-nine AUD patients (22 without KS and 7 with KS) and 15 healthy controls underwent a neuropsychological assessment and a polysomnography. The severity of sleep-disordered breathing and sleep fragmentation was similar in AUD and KS patients compared to controls. Sleep architecture differed between both patient groups: the proportion of slow-wave sleep was reduced in AUD patients only, while a lower proportion of rapid-eye movement (REM) sleep was specifically observed in KS patients. The proportion of REM sleep correlated with the severity of episodic memory deficits when AUD and KS were examined together. These data provide evidence for both similarities and specificities regarding sleep alterations in AUD patients with and without KS. They also indicate that altered sleep architecture may contribute to the pathophysiology of alcohol-related memory disorders.

SUBMITTER: Laniepce A

PROVIDER: S-EPMC10058993 | biostudies-literature | 2023 Mar

REPOSITORIES: biostudies-literature

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Distinct Sleep Alterations in Alcohol Use Disorder Patients with and without Korsakoff's Syndrome: Relationship with Episodic Memory.

Laniepce Alice A Segobin Shailendra S André Claire C Bertran Françoise F Boudehent Céline C Lahbairi Najlaa N Maillard Angéline A Mary Alison A Urso Laurent L Vabret François F Cabé Nicolas N Pitel Anne-Lise AL Rauchs Géraldine G

Journal of clinical medicine 20230322 6

Alcohol Use Disorder (AUD) results in sleep disturbances that may have deleterious impacts on cognition, especially on memory. However, little is known about the sleep architecture in patients with Korsakoff's syndrome (KS). This study aims at characterizing sleep disturbances in KS compared to AUD without KS and at specifying the relationships with cognitive impairments. Twenty-nine AUD patients (22 without KS and 7 with KS) and 15 healthy controls underwent a neuropsychological assessment and ...[more]

PMID: 36983439

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Project description:Alcohol use disorder is a chronic disease characterized by an inappropriate pattern of drinking, resulting in negative consequences for the individual's physical, mental and social health. Korsakoff's syndrome is a complication of alcohol use disorder and is characterized by severe memory and executive deficits. The fronto-cerebellar and Papez circuits are structurally affected in patients with alcohol use disorder with and without Korsakoff's syndrome. The first objective of the present study was to measure the effect of chronic and excessive alcohol consumption on resting-state functional connectivity of these two functional brain networks. The second objective was to identify, for the first time, resting-state functional connectivity abnormalities specific to amnesic patients with Korsakoff's syndrome. In the present study, a neuropsychological assessment and a resting-state functional magnetic resonance imaging examination were conducted in 31 healthy controls (43.6 ± 6.1 years) and 46 patients (46.6 ± 9.1 years) with alcohol use disorder including 14 patients with Korsakoff's syndrome (55.5 ± 5.3 years) to examine the effect of chronic and heavy alcohol consumption on functional connectivity of the fronto-cerebellar and the Papez circuits at rest and the specificity of functional connectivity changes in Korsakoff's syndrome compared to alcohol use disorder without Korsakoff's syndrome. The resting-state functional connectivity analyses focused on the nodes of the fronto-cerebellar and Papez circuits and combined region of interest and graph theory approaches, and whether these alterations are associated with the neuropsychological profile. In patients pooled together compared to controls, lower global efficiency was observed in the fronto-cerebellar circuit. In addition, certain regions of the fronto-cerebellar and Papez circuits were functionally hyperconnected at rest, which positively correlated with executive functions. Patients with Korsakoff's syndrome showed lower resting-state functional connectivity, lower local and global efficiency within the Papez circuit compared to those without Korsakoff's syndrome. Resting-state functional connectivity positively correlated with several cognitive scores in patients with Korsakoff's syndrome. The fronto-cerebellar and Papez circuits, two normally well-segregated networks, are functionally altered by alcohol use disorder. The Papez circuit attempts to compensate for deficits in the fronto-cerebellar circuit, albeit insufficiently as evidenced by patients' overall lower cognitive performance. Korsakoff's syndrome is characterized by altered functional connectivity in the Papez circuit known to be centrally involved in memory.

Project description:OBJECTIVE:Patients with Korsakoff's syndrome (KS) have difficulty carrying out tasks which rely on prospective memory (PM). Since remembering to carry out an action in the future is crucial for living independently, it is of primary interest to develop strategies that improve PM performance in KS patients. DESIGN:The study employed a computer categorization task as an ongoing activity into which a PM task was embedded. We included episodic future thinking (EFT) and observational learning (Experiment 2) to boost PM. METHODS:Experiment 1 evaluated the efficacy of EFT following written PM task instructions in ten KS patients. Due to floor-level PM performance in Experiment 1, Experiment 2 included an instructional video demonstrating the PM intention. In Experiment 2, twenty-six KS patients performed both conditions (EFT and no-EFT) at least 1 week apart, while twelve controls with alcohol use disorder without KS performed the no-EFT condition. In Experiment 2, the PM instructions were also shown through video (observational learning component). Mild cognitive impairment was assessed in a short test battery. RESULTS:Experiment 1 showed overall floor performance in both conditions. Experiment 2 showed that KS patients performed PM tasks less accurately than the control group in the no-EFT condition. In Experiment 2, where the observational learning component was included, EFT improved PM performance in KS patients. This effect was driven by a sub-group of high-functioning KS patients. CONCLUSIONS:This study showed the value of an observational learning component together with EFT in improving PM performance, in relatively high-functioning KS patients. PRACTITIONER POINTS:KS patients performed the PM task less accurately than non-KS controls with alcohol use disorder, confirming PM impairment in this patient population. Controls with alcohol use disorder performed the PM task at ceiling level. Showing an instructional video demonstrating the PM intention improved PM performance and later recall of PM task instructions in KS patients. Episodic future thinking strategy improved PM performance in KS patients with relatively intact cognitive functioning.

Dataset Information

Distinct Sleep Alterations in Alcohol Use Disorder Patients with and without Korsakoff's Syndrome: Relationship with Episodic Memory.

Publications

Distinct Sleep Alterations in Alcohol Use Disorder Patients with and without Korsakoff's Syndrome: Relationship with Episodic Memory.

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