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Brain Advance Access originally published online on November 26, 2008
Brain 2009 132(2):369-376; doi:10.1093/brain/awn311
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© The Author (2008). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Mammillothalamic functional connectivity and memory function in Wernicke's encephalopathy

Eosu Kim1,2, Jeonghun Ku3, Kee Namkoong1,2, Wonho Lee3, Kang Soo Lee1,2, Ji-Yeon Park1, Su Young Lee1, Jae-Jin Kim1,2, Sun I. Kim3 and Young-Chul Jung1,2

1 Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea 2 Department of Psychiatry, Severance Mental Health Hospital, Gwangju, Gyeonggi-do, Korea 3 Department of Biomedical Engineering, Hanyang University, Seoul, Korea

Correspondence to: Young-Chul Jung, Department of Psychiatry, Yonsei University College of Medicine, Severance Mental Health Hospital, 696-6 Tanbeol-dong, 464-100 Gwangju-si, Gyeonggi-do, Korea E-mail: eugenejung{at}yuhs.ac

There is still debate over the neural mechanisms underlying pathogenic and even recovery processes of Wernicke's encephalopathy. Therefore, we attempted to validate the usefulness of resting-state functional connectivity analysis in assessing memory function and its neural correlation with the mammillothalamic tract in patients recovering from Wernicke's encephalopathy. Seven chronic alcoholics recovering from Wernicke's encephalopathy, 14 alcoholic comparisons without Wernicke's encephalopathy, and 14 healthy comparisons underwent functional connectivity MRI scans, as well as verbal and non-verbal memory tests after at least a 1 month abstinence from alcohol. Resting-state functional connectivity strength between the anterior thalamus and the mammillary bodies was investigated by calculating temporal correlations in magnetic resonance signal levels between the two regions during a 5-min passive viewing task. The mean values of the functional connectivity strength between the left anterior thalamus and the ipsilateral mammillary body differed significantly between Wernicke's encephalopathy patients and healthy comparisons (P = 0.014). This connectivity strength in alcoholic comparisons fell between those of the former two groups, with a significant difference from that of healthy comparisons (P = 0.038). In addition, the strength of this left-sided functional connectivity significantly correlated with delayed verbal recall scores (r = 0.771, P = 0.042) and verbal recognition score (r = 0.825, P = 0.022) in patients with Wernicke's encephalopathy. Our findings indicate that memory function in patients recovering from Wernicke's encephalopathy parallels the level of the mammillothalamic functional connectivity; this supports the usefulness of resting-state functional connectivity analysis as a practical alternative to pathological examination of the mammillothalamic tract in living patients with Wernicke's encephalopathy.

Key Words: Wernicke's encephalopathy; memory; mammillothalamic tract; resting-state functional connectivity

Received July 23, 2008. Revised October 2, 2008. Accepted October 30, 2008.


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