Function and Dysfunction of Prefrontal Brain Circuitry in Alcoholic Korsakoff’s Syndrome

The signature symptom of alcohol-induced persisting amnestic disorder, more commonly referred to as alcoholic Korsakoff’s syndrome (KS), is anterograde amnesia, or memory loss for recent events,
and until the mid 20th Century, the putative brain damage was considered to be in diencephalic and medial temporal lobe structures.
Overall intelligence, as measured by standardized IQ tests, usually remains intact. Preservation of IQ occurs because memories
formed before the onset of prolonged heavy drinking—the types of information and abilities tapped by intelligence tests—remain
relatively well preserved compared with memories recently acquired. However, clinical and experimental evidence has shown
that neurobehavioral dysfunction in alcoholic patients with KS does include nonmnemonic abilities, and further brain damage
involves extensive frontal and limbic circuitries. Among the abnormalities are confabulation, disruption of elements of executive
functioning and cognitive control, and emotional impairments. Here, we discuss the relationship between neurobehavioral impairments
in KS and alcoholism-related brain damage. More specifically, we examine the role of damage to prefrontal brain systems in
the neuropsychological profile of alcoholic KS.