Tag Archives: alcohol

Korsakoff Syndrome: inventing memories to compensate forgetfulness

Korsakoff syndrome is a memory problem that is usually due to alcohol abuse or overly restrictive diets that lead to vitamin deficiency. Find out here what it consists of, what are its main symptoms, causes, treatment and how we prevent it.

Korsakoff Syndrome

What is the Korsakoff Syndrome?

Korsakoff syndrome is a chronic memory disorder due to severe deficiency of thiamine, or vitamin B1.

Thiamin helps the brain produce energy from sugar. When levels fall drastically brain cells can’t generate enough energy to function properly and as a result, Korsakoff syndrome can develop.

It is believed that this deficiency causes damage to the thalamus and mammillary bodies of the hypothalamus. Mammillary bodies are brain parts or small structures with many connections to the hippocampus (an area closely related to memory). There is also general brain atrophy, loss, and neuronal damage.

Research has shown that this deficiency alters the substances responsible for transmitting signals between brain cells and storing memories. These alterations can destroy neurons and cause bleeding and microscopic scars throughout the brain tissue.

This syndrome is often, but not always, preceded by an episode of Wernicke’s encephalopathy. This consists of an acute reaction of the brain due to a severe lack of thiamine. Wernicke’s encephalopathy is a medical emergency that causes severe life-threatening brain disturbance, mental confusion, uncoordinated movement and abnormal and involuntary eye movements. Because Korsakoff syndrome is commonly preceded by an episode of Wernicke’s encephalopathy, the chronic disorder is sometimes called Wernicke-Korsakoff syndrome. However, Korsakoff can develop without a previous episode of this encephalopathy.

Korsakoff Syndrome Symptoms

Korsakoff is characterized by memory problems but retaining consciousness. This may give the impression during conversations that he is in full possession of his faculties.

However, he has severe alterations in recent memory. The person will ask the same questions over and over again, read the same page for hours, and is not able to recognize the people they have seen several times in the course of his illness.

Memory problems can be very severe, both short-term memory and long-term memory with many memory gaps or memory loss, while other skills such as social or thoughts may be relatively intact.

The main symptoms are:

  • Anterograde amnesia: inability to form new memories or learn new information.
  • Retrograde amnesia: severe loss of existing memories, prior to the beginning of the disease.
  • Confabulations: invented memories that are believed by the individual himself as real because of memory gaps.
  • Conversation with low content.
  • Lack of introspection.
  • Apathy.

Individuals with Korsakoff syndrome may show different symptoms. In some cases, a patient may continue to “live in the past”, convinced that his life and the world remain unchanged since the beginning of the disorder.

Others may display a wide variety of confabulations. Retrograde amnesia does not happen to all memories alike but affects more in recent events. The older the memories, the more they remain intact. This may be because recent memories are not fully consolidated in our brains, therefore, being more vulnerable to their loss.

Confabulations in Korsakoff Syndrome

One of the most characteristic symptoms of people with Korsakoff syndrome is the confabulations. They often “collude” or invent information they can’t remember. It is not that they are “lying”, but actually believe their invented explanations. There is still no agreed scientific explanation as to why this happens.

Korsakoff Syndrome-Confabulations

Some people may show constant, even frenetic, conspiracies. They continually invent new identities, with detailed and convincing stories that support them, to replace the reality they have forgotten.

Causes of Korsakoff Syndrome

We know that excessive intake of alcohol can harm our nervous system. In fact, in most cases, Korsakoff’s syndrome is due to alcohol abuse and its consequences on our brain.

Research has identified some genetic variations that may increase the risk of this disorder. In addition, poor nutrition can also be an important factor.

Korsakoff syndrome can also be caused by eating disorders, such as anorexia, overly restrictive diets, starvation, or sudden weight loss after surgery. Also by uncontrolled vomiting, HIV virus, chronic infection or cancer that has spread throughout the body.

Treatment of Korsakoff Syndrome

Intervention for Korsakoff syndrome should be approached from a multidisciplinary point of view, in which doctors, psychologists, and neuropsychologists will work to achieve the best results.

Some experts recommend that people who consume large amounts of alcohol or have other risks of thiamine deficiency, take oral supplements, always under the supervision of a doctor.

It is also recommended that anyone who has had a history of alcohol abuse or symptoms associated with Wernicke’s encephalopathy be injected with thiamine. For people who develop Korsakoff Syndrome, treatment with oral thiamine, other vitamins and magnesium may increase the chances of symptoms improving.

A psychological intervention will revolve around maintaining alcohol abstinence. From the neuropsychological point of view, it will help to compensate for their deficits, so that the patient can integrate socially and lead a life as normal as possible. CogniFit is a tool that trains different cognitive skills affected by Korsakoff Syndrome. 

Prognosis of Korsakoff syndrome

Some data suggest that about 25 percent of people with Korsakoff syndrome recover, half improve but don’t fully recover, and another 25 percent remain the same.

According to these researchers, the mortality rate is high, between 10 and 20%. This is mainly due to lung infection, septicemia, liver decompensation disorder and an irreversible thiamine deficiency state.

Early attention and treatment for Korsakoff symptoms is very important. Early treatment of Wernicke’s encephalopathies may improve prognosis and prevent Korsakoff’s syndrome. For example, eye problems begin to improve in hours or days, motor problems, in days or weeks. Although some 60% of patients may have some residual symptoms.

According to these authors, once the Korsakoff syndrome has been established, the prognosis is quite pessimistic. Approximately 80% of patients are left with a chronic memory disorder. These can get to learn simple and repetitive tasks that involve procedural memory (motor memory).

Cognitive recovery is slow and incomplete and reaches its highest level of recovery after one year of treatment. Although recovery may occur, it depends on factors such as age or alcohol withdrawal.

Tips for Preventing Korsakoff Syndrome

Tips for Preventing Korsakoff Syndrome

The primary advice is to reduce your alcohol intake to a minimum. The less alcohol, the better. Although we think that drink very little, the fact is that even in small amounts, we are already damaging our body.

  • A healthy and non-restrictive diet will ensure the synthesis of the vitamins needed to function properly and in particular thiamine or B1.
  • Go to the doctor whenever we detect memory problems. He will establish if it is a problem associated with normal aging or some kind of dementia.
  • Maintain a good support system, since loved ones will be of help in case any disturbing symptoms appear.
  • If you think you drink more than you do and don’t know how to quit, go to a professional who will help you reduce your alcohol intake.

Feel free to leave a comment below.

This article is originally in Spanish written by Andrea García Cerdán, translated by Alejandra Salazar.

8 Way to Show Support to an Alcoholic As You Work Through Family Therapy

Your loved one has worked hard throughout their treatment program to learn better ways to manage their addiction. Now, they are asking you to attend family therapy sessions to work through the issues that are associated with their alcohol abuse. While some people find the prospect of sharing their struggles in a counseling session a little nerve-inducing, this is an important opportunity for you to show your support. In fact, just being invited into your loved one’s therapy program is a gesture of honor since it means that you play an important role in their life. As you take this important journey with your loved one, use these strategies to promote effective family therapy sessions that allow everyone to benefit from healing their relationship.

Family therapy

1. Come with an Open Mind

Views regarding family therapy can differ among members of your group. If you have never been in counseling before, then you may have misconceptions regarding what will happen. For example, some people think counseling sessions are designed to point out where people are going wrong, but this is not the case. During your family counseling sessions, your loved one’s alcoholism and current treatment plan will be discussed. You will also have a chance to talk about how their behavior has affected your life. However, the main purpose of every one of your sessions will be to find solutions for the challenges that you face together. Having an open mind allows you to fully take in the lessons gleaned from the topics you explore in your sessions.

2. Share Your Feelings

Baring your soul to a stranger can feel odd at first. However, you should keep in mind that family counselors have heard it all. They are not there to judge you. Instead, their role in the session is to try to help by staying neutral as they guide you and your loved one through exercises and conversations that help you work through your challenges. Be willing to open up about how you feel, and remember that it is okay to ask for time to compose your thoughts when you are dealing with a painful topic. Anger, guilt and even sadness are all normal emotional responses to an alcoholic’s recovery. Addressing these emotions is important for being in a place where you can offer your loved one your full support.

3. Acknowledge Their Experiences

When your loved one was in the throes of alcoholism, it is likely that you had vastly different life experiences. This sometimes makes it hard to connect with your loved one as they go through recovery. For example, you may feel as though they were living it up while you were trying to keep your household together. Meanwhile, they may describe the pain of knowing that they were no longer in control of their drinking. Acknowledging that your loved one may have felt something emotionally that wasn’t obvious to you at the time is a powerful way to let them know that their feelings are valid.

Family therapy

4. Work on Improving Your Communication Strategies

Families often struggle with breakdowns in communication that contribute to angry outbursts and hurt feelings. Substance abuse contributes to communication issues because your loved one may have been using their drinking to avoid having to actually talk about the things that bothered them. Learning to communicate effectively takes time, and your counselor will guide you throughout the process. For instance, they may have you work with your partner to develop listening skills that stop the cycle of never fully resolving any issues. Be patient as you learn to communicate together, and know that the extra effort will pay off when you can work through a conflict together using positive language that shows respect for both of your opinions.

5. Prepare Mentally

Alcoholism sometimes influences painful events to occur in families. Domestic violence, infidelity, and other addictions may all coexist with an alcohol problem. As a family member of someone who drinks, you may have dealt with painful experiences in the past that will be brought up in your sessions. Be ready for this, and know that painful emotions must sometimes rise to the surface before you can fully find healing.

6. Be Consistent with Your Attendance

It sounds so simple, but just showing up to your sessions regularly makes a big difference in your loved one’s recovery. When you commit to attending family therapy, you let your loved one know that their well-being and your relationship are priorities that are worth working hard to protect. Make sure to plan your counseling sessions so that you do not have interruptions from work or other obligations. If you must miss a session, let your partner know as soon as possible so that you don’t let them down.

7. Do Your Individual Work

With so much focus on your loved one’s alcoholism, it is possible that some of your issues may have been overlooked. It is common for personal situations to arise during family counseling that need to be addressed in individual sessions. Although it can be upsetting to suddenly discover that you are dealing with low self-esteem or problems with codependency, finding ways to overcome your personal challenges helps your family as a whole.

8. Follow Through at Home

Being a perfect partner in your family counseling sessions and forgetting everything you learned once you get home is ineffective for your partner’s recovery. Make sure to remind each other to use your communication strategies when conflicts arise and avoid tempting your loved one by keeping alcoholic beverages around. Finding ways to minimize stress will also ease the process of healing together. Should an issue arise that you are not sure how to address, bring it to your counselor in an upcoming session. This way, minor issues do not have time to fester into major problems that affect your relationship.

Showing support to your loved one is important for their recovery, and attending family counseling sessions provides you with guidance to overcome the adversities you face together. By making it a priority to show up, contribute and follow through on what you learn together, you can rebuild your relationship while helping your loved one to stay sober.

 

Migraine Triggers: What are Migraines and How to Avoid Them

Knowing migraine triggers may help you avoid them

What are migraines?

Though migraines are common (migraines and tension type headaches are the second and third most common disease in the world) the exact cause of migraines is still not fully understood. However, specialists have been able to determine common migraine triggers. Knowing what these triggers are might help you prevent a future migraine by avoiding the migraine triggers that we’ll talk about below.

Migraines are ranked as the seventh most disabling disease among all diseases globally, and the leading cause of disability among all neurological disorders. Migraines and headaches are leading causes of outpatient and emergency department visits and are particular issues for women during their reproductive years. However, many people who suffer from migraines and headaches do not receive adequate treatment and care, instead choosing to rely on over the counter medications, such as ibuprofen and acetaminophen. Healthcare and lost working days due to migraines cost as much as $36 billion in the US alone.

According to the World Health Organization (WHO), there are four types of headache disorders:

  • Migraines
  • Tension type headaches
  • Cluster headaches
  • Medication overuse headaches

Migraines will often begin in childhood, mostly during puberty, and mostly affects those between 35 and 45 years old, but recurs over the lifetime. It is also twice as common in women than men, mostly due to hormonal differences. Migraine frequency can vary from between once a week to once a year.

Different types of neurotransmitters

Though the causes are not completely understood, it appears to result from a combination of genetics and environmental factors. Brain chemistry, such as the lowering of serotonin levels, may be a factor, but researchers are still studying the role of serotonin in the brainstem. Migraines are thought to be the result of the activation of a mechanism in the brain, which releases the inflammatory substances around the nerves and blood vessels of the head that causes a migraine. You can tell you have a migraine as opposed to a regular headache because your headache will be:

  • Moderate or severe
  • Pulsating
  • On one side of your head
  • Aggravated by movement
  • Lasting from hours to 2-3 days

If your headache has all of these features, accompanied by nausea and sensitivity to light and sound, you’re probably experiencing a migraine. Hopefully, this list is helpful in avoiding potential triggers and future migraine attacks.

15 Common Migraine Triggers

Stress

It’s well known how bad stress is for the body. Stress is the most commonly reported migraine trigger, most likely because it is so personal and difficult to control. Stress can cause more frequent migraine attacks, make migraine attacks worse, and make migraine attacks last longer. Even after the stressful situation ends, the sudden release of tension can cause a migraine to occur – this is called a weekend migraine. Though it is virtually impossible to avoid stress, you can learn ways to manage it better, such as eating healthy, exercising regularly, and learning relaxation techniques, like yoga or meditation.

Hormone changes

Since migraines affect twice as many women as men, it’s no surprise that hormones play a large part. Fluctuations in estrogen seem to be the trigger for many women. Those with a previous history of migraines often report that they have headaches before or during their periods when estrogen levels are at their lowest. Hormone medications, such as contraceptives and hormone replacement therapy have been reported to either worsen or help migraines, depending on the woman.

Sleeping in

Changes in sleeping patterns can trigger a migraine, which is why it’s important to try to wake up around the same time every day. Sleeping in may cause what’s known as a “weekend migraine” especially if there is a large difference between your weekday and weekend timetables.

Too much or not enough sleep may be migraine triggers

Lack of sleep

On the other hand, fatigue and a lack of sleep is also a very common migraine trigger. Fatigue can also be a warning sign for an impending migraine attack. Either way, it seems that any kind of sleep disturbance is a trigger for many people, and you should try to go to sleep and wake up at the same time every day regardless of it’s a weekday or weekend.

Perfume

Many migraine sufferers report that attacks are triggered by strong perfume and other strong odors. Additionally, osmophobia is an aversion to that is a unique characteristic of migraine sufferers, during their attacks.

Weather and barometric pressure changes

Weather can cause changes in brain chemistry causing a migraine, especially on days with bright sunlight, extreme heat or cold, pressure changes, or high humidity. Even though you can’t change the weather, you can track what weather conditions are your personal triggers, if any, and stay indoors or take migraine medications at the first signs of a migraine.

Alcohol

Alcohol increases blood flow to the brain, which can cause a migraine. Any kind of alcohol can act as a migraine trigger, but it seems to be particularly red wine, especially in women.

Medications

Self treating with medication can be a double-edged sword; taking too much can lead to a medication overuse headache, which are caused by chronic and excessive use of medications used to treat headaches.

Caffeine

Unfortunately, caffeine can act as both a trigger and treatment for migraines. You just have to be aware if you are sensitive to caffeine, and carefully monitor how caffeine affects you.

Cheese

Tyramine is a substance that is produced as the protein in a food or drink ages. It’s not sure why tyramine causes migraines, but it can be found in in foods like aged cheeses, processed meats, dried fruits, and even red wine.

Sex

Any kind of fervent physical activity can cause headaches and migraines, including sex.

Dehydration

Dehydration and hunger are bad for the body overall, and one of the results can be a headache or migraine. People who suffer from migraines should try not to skip meals and drink plenty of water.  

Food additives

Artificial sweeteners, and preservatives such as sulfites and nitrates can trigger a migraine.

Tannins

Tannins are found in red wine, but they are also found in teas, red apples, and pears. Tannins are flavonoids mostly found in the skins of the fruits which give those foods and drinks their bitter taste.

Bright lights or loud sounds

Bright, flickering, or pulsating lights can be a trigger for a migraine attack. Unfortunately for some, bright sunlight on its own can be a trigger for some migraine sufferers.

Bright lights and flashing lights may be migraine triggers

Migraines are so prevalent, but so treatable, why is this? There seems to be a stigma around seeking treatment for headaches; as a chronic migraine sufferer myself, I also prolonged seeking treatment because I believed I could just self medicate with pain relievers. Keep in mind that many of these triggers act in combination with each other, so keeping a sort of headache journal can help narrow down your own personal migraine triggers, avoid future migraine attacks, and be helpful in describing your migraine disorder to your physician.

Questions? Leave me a comment below!

References:

Burch RC, Loder S, Loder E, Smitherman TA. The prevalence and burden of migraine and severe headache in the United States: updated statistics from government health surveillance studies. Headache. 2015 Jan;55(1):21-34. doi: 10.1111/head.12482.

Cutrer FM, et al. Pathophysiology, clinical manifestations and diagnosis of migraine in adults. 2015.

Dalkara, T. & Kılıç, K. Current Pain and Headache Report (2013) 17: 368. doi:10.1007/s11916-013-0368-1.

Fukui, PT, Gonçalves, TRT, Strabelli, CG, Lucchino, NF, Matos, FC, Santos, JPM, Zukerman, E, Zukerman-Guendler, V, Mercante, JP, Masruha, MR, Vieira, DS, & Peres, MFP. (2008). Trigger factors in migraine patients. Arquivos de Neuro-Psiquiatria, 66(3a), 494-499. https://dx.doi.org/10.1590/S0004-282X2008000400011

Houle TT, Butschek RA, Turner DP, Smitherman TA, Rains JC, Penzien DB. Stress and Sleep Duration Predict Headache Severity in Chronic Headache Sufferers. Pain. 2012;153(12):2432-2440. doi:10.1016/j.pain.2012.08.014.

Steiner TJ, Stovner LJ, Birbeck GL. Migraine: the seventh disabler. The Journal of Headache and Pain. 2013;14(1):1. doi:10.1186/1129-2377-14-1.

Tekatas A, Mungen B. Migraine headache triggered specifically by sunlight: Report of 16 cases. European Neurolology. 2013;70:263-266

Triggers: Environmental and physical factors. National Headache Foundation.

Weather-related migraines. Neurology Now. 2013;9:12.

World Health Organization (WHO)

 

More on CogniFit’s brain games

5 Myths about the Brain

5 Myths about the Brain

5 Myths About the Brain

The brain is truly an amazing organ. It is extremely intricate, and without it, we would not be able to function. While the brain has many interesting facts about it, there are many misconceptions that seem to be accepted as fact. These brain myths are often exposed in our mainstream society. Some of these myths are completely wrong, and some of these are simply misinterpreted. Here are five interesting myths about the brain.

1. We Use 10% of Our Brains: This is arguably the biggest and most common misconception about the brain. It has been linked to many sources, including Albert Einstein. However his take on it was taken out of context. It is somewhat emphasized in mainstream media, and it is a sexy topic for cinema. Those are the reasons so many people believe it. In fact, some movies and books say if we access the other 90% of our brains, we can gain psychic abilities. Lets just say there is zero scientific evidence of that. The fact is we use every part of our brain virtually all the time, including when we are sleeping.

2. A Person is Either “Right Brained” or Left Brained”: With this myth, there many online quizzes you can take that tell you if you are “right brained or left brained.” According to this myth, right-brained people are supposedly more creative and artistic. On the other hand, left brained people are more logical and analytical. The fact is we use both sides of the brain equally, and the sides are co-dependent of each other.

3. Brain Damage is Permanent: This is only applicable if the brain is severely damaged. With severe damage, surgery is always required. However, with minor to moderate brain injuries, we can usually recover from them. Brain injury can be defined as an injury of the brain regardless of age at onset. Brain injuries can result in a substantial handicap to the person who sustained the brain injury and can cause various forms of cognitive impairments and symptoms such as concentration, memory or motor disorder. In most cases, people usually recover from a mild concussion.

4. Alcohol Destroys Brain Cells: Moderate alcohol intake doesn’t kill neurons, or even damage them. That’s because the amount of alcohol needed to kill brain cells would kill the person drinking it first! That doesn’t mean that alcohol can’t damage the brain, though. A high alcohol intake can have detrimental effects on the brain. Alcohol kills dendrites, which are connections of neurons that connect to other neurons. These dendrites help neurons send messages to each other. With the dendrites damaged, heavy drinkers cognitive abilities are impaired. However, these dendrites can be repaired with therapy.

5. Drug Use Can Lead to Having Holes in Your Brain: We have all seen the drug commercials about the debilitating effects they have on the brain. While severe drug use can have negative side-effects, it does not lead to having holes in your brain. This myth may have been created to scare people about the consequences of drug use. The truth is, only physical trauma can do this.

Brain protein called vimentin can indicate damage to the hippocampus following binge drinking

Brain protein called vimentin can indicate damage to the hippocampus following binge drinking.

Chronic drinking is known to have detrimental health effects such as cardiac and liver problems, cognitive impairments, and brain damage. Binge drinking in particular is known to increase the risk of developing dementia and/or brain damage, yet little is known about an exact threshold for the damaging effects of alcohol. A study using rodents to examine various markers of neurodegeneration has found that brain damage can occur with as little as 24 hours of binge-like alcohol exposure.

Is there a neurological reason behind teen drinking?

Scientists have unpicked the brain processes involved in teenage alcohol abuse and say their findings help explain why some young people have more of a tendency to binge drink.

A study published in the Proceedings of National Academy of Sciences (PNAS) journal found that a gene known as RASGRF-2 plays a crucial role in controlling how alcohol stimulates the brain to release dopamine, triggering feelings of reward. “If people have a genetic variation of the RASGRF-2 gene, alcohol gives them a stronger sense of reward, making them more likely to be heavy drinkers,” said Gunter Schumann, who led the study at King’s College London’s Institute of Psychiatry. A bad habit for brain health.

Fetal alcohol exposure affects brain structure in children

Fetal alcohol exposure affects brain structure in children.

Children exposed to alcohol during fetal development exhibit changes in brain structure, brain function and metabolism that are visible using various imaging techniques, according to a new study being presented November 25 at the annual meeting of the Radiological Society of North America (RSNA).