Introduction

Alcoholic brain damage was, until fairly recently, viewed as existing in two major forms: the alcoholic Korsakoff syndrome and alcoholic 'dementia'. Most 'alcoholics' suffering long-term cognitive impairment were thought to fit into the clearly defined Korsakoff category. A smaller proportion, with 'widespread cerebral dysfunction of an uncertain nature' was included in the poorly defined category of alcoholic 'deterioration' or 'dementia'. (12)

The alcoholic Korsakoff syndrome, caused by thiamine deficiency, has been the focus of comprehensive research (it should be noted that the chronic Korsakoff syndrome does not respond to thiamine). Research into the aetiology of alcoholic 'dementia' has been less rigorous, but evidence for the direct neurotoxic effect of alcohol has been suggested by neuropathological and neuroimaging studies, and by animal experiments. (The Korsakoff syndrome is considered in Ch§pleLl.1:13.)

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