Comparative neuropsychology and Korsakoff's syndrome. I—Spatial and visual reversal learning

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Abstract

Alcoholic Korsakoff's disease is associated with widespread cerebral damage. Damage to the hippocampus and its major connections has been linked directly to the severe anterograde amnesia observed in Korsakoff patients. However, since other brain regions also are destroyed with chronic alcoholism, a thorough description of any additional behavioral abnormalities is essential to understanding the alcoholic Korsakoff syndrome. Using spatial and visual reversal-learning paradigms popular in comparative and physiological psychology, we have observed profound defects in the formation of stimulus-reinforcement associations by a group of 12 Korsakoffs in comparison to 13 alcoholic and 11 aphasic control subjects. A group of 15 patients with Huntington's disease showed severe deficits on visual but not spatial reversals, and their poor visually-based performance was qualitatively different from that of the Korsakoff patients.

Résumé

Le syndrome de Korsakoff alcoolique comporte des atteintes cérébrales diffuses. On a mis en rapport l'atteinte de l'hippocampe et ses connections principales avec la grave amnésie antérograde qu'on observe chez ces lalades. Cependent, puisque d'autres régions du cerveau sont aussi détruites, une description précise de toutes les anomalies comportementales est essentielle pour comprendre le syndrome. En utilisant les paradigmes de renversement d'apprentissage visuel très utilisés en psychologie comparative et physiologique, nous avons observé de graves déficits dans la formation des association stimulusréenforcement dans un groupe de 12 Korsakoff comparés à 13 alcooliques et à 11 aphasiques de contrôle. Un groupe de 15 sujets avec maladie d'Huntington montrait des déficits sévères sur les renversements visuels mais non sur les spatiaux et leur mauvaise performance visuelle était qualitativement différente de celle des Korsakoff.

Zusammenfassung

Die alkoholische Korsakoff-Krankheit kommt bei ausgedehnter Hirnschädigung vor. Die Schädigung des Hippokampus und seiner hauptsächlichen Nervenverbindungen ist in direkte Beziehung zu der schweren anterograden Amnesie bei Korsakoff-Patienten gesetzt worden. Da jedoch auch andere Hirnregionen bei chronischem Alkoholabusus geschädigt werden, ist eine eingehende Beschreibung aller eventuell zusätzlichen Verhaltensabnormitäten für das Verständnis des alkoholischen Korsakoff-Syndrome wichtig. Bei Anwendung der in der vergleichenden tierexperimentellen und physiologischen Psychologie üblichen Versuchspläne zum Umlernen unter räumlichen und visuellen Stimulusbedingungen haben wir bei 12 Korsakoff-Patienten im Vergleich mit 13 Alkoholikern und 11 Aphasikern als Kontrollpersonen erhebliche Defekte in der Bildung der Verknüpfung zwischen Stimulus und Verstärker beobachtet. 15 Patienten mit Chorea Huntington zeigten schwere Beeinträchtigung beim visuellen aber nicht beim räumlichen Umlernen, und ihre schlechten Leistungen in visuellen Lernversuchen unterschieden sich zudem qualitativ von denen der Korsakoff-Patienten.

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