User:Jth8769/Wernicke–Korsakoff syndrome

Function of Thiamine in the body
The vitamin thiamine also referred to as Vitamin B1, is required by three different enzymes to allow for conversion of ingested nutrients into energy. Thiamine can not be produced in the body and must be obtained through diet and supplementation. The duodenum is responsible for absorbing Thiamine and the liver can store Thiamine for 18 days. Prolonged and frequent consumption of alcohol causes a decreased ability to absorb thiamine in the duodenum, it also is related to malnutrition from poor diet, and impaired use of thiamine by the cells along with impaired storage in the liver. Without thiamine the Kreb's Cycle enzymes pyruvate dehydrogenase complex (PDH) and alpha-ketoglutarate dehydrogenase (alpha-KGDH) are impaired. The impaired functioning of the Kreb's Cycle results in inadequate production of adenosine triphosphate (ATP) or energy for the cells functioning. Energy is required by the brain for proper functioning and use of its neurotransmitters. Injury to the brain occurs when neurons that require high amounts of energy from thiamine dependent enzymes are not supplied with enough energy and die.

Signs and Symptoms
DSM-V now classifies Korsakoff syndrome under Substance/Medication-Induced Major or Mild Neurocognitive Disorders, specifically alcohol-induced amnestic confabulatory. The diagnostic criteria defined as necessary for diagnosis includes, prominent amnesia, forgetting quickly, and difficulty learning. Presence of thiamine deficient encephalopathy can occur in conjunction with these symptoms.

Prognosis
25% of WKS patients will require long term care.

Epidemiology
WKS occurs more frequently in men than women and has the highest prevalence in the ages 55-65 approximately 71% are unmarried.

Diagnosis
A true diagnosis of WE can be made from a post mortem brain examination.

Prevention
Daily recommendations of thiamine requirements are 0.66mg/2,000kcal daily or 1.2 mg for adult men and 1.1mg for adult women per day.