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Psychiatry · Substance use: neuroanatomy of Korsakoff syndrome
Sample itemA man with long-standing alcohol dependence has severe anterograde amnesia and confabulation. At autopsy, which structures are characteristically damaged?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
D. Mamillary bodies and dorsomedial thalamic nucleus
Korsakoff syndrome follows thiamine deficiency and damages the diencephalic memory circuit, namely the mamillary bodies and the dorsomedial nucleus of the thalamus. Frontal dysfunction also contributes to confabulation and poor insight.
Option by option
A. Caudate nucleus and putamen
The caudate and putamen are affected in Huntington disease, causing chorea.
B. Locus coeruleus and raphe nuclei
The locus coeruleus and raphe nuclei are brainstem monoamine nuclei and are not the usual site of Korsakoff damage.
C. Hippocampal CA1 neurons and amygdala
CA1 hippocampal neurons are vulnerable to hypoxia and are the classic site of damage in global anoxia.
D. Mamillary bodies and dorsomedial thalamic nucleus (correct)
Correct. These diencephalic structures are the characteristic site of damage.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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