Thiamine Deficiency, Clinical Manifestations and Treatment of Wernicke-Korsakoff Syndrome

Wernicke-Korsakoff syndrome (WKS) is a severe, debilitating neurodegenerative disorder resulting from thiamine deficiency, which disrupts normal cellular functions within the brain, particularly in regions crucial for memory and cognitive processes.It is characterized by two distinct but often overlapping conditions: Wernicke's encephalopathy (WE) and Korsakoff's psychosis (KP).Thiamine deficiency impacts various biological processes, including glucose metabolism, neurotransmitter synthesis, myelin sheath integrity, and nerve conduction.In glycolysis, thiamine is a cofactor for pyruvate dehydrogenase (PDH), aiding in the conversion of pyruvate to acetyl-CoA within the tricarboxylic acid (TCA) cycle.Thiamine also serves as a cofactor for α-ketoglutarate dehydrogenase (α-KGDH) in the TCA cycle, contributing to the generation of reducing cofactors Журнал «Перспективи та інновації науки» (Серія «Педагогіка», Серія «Психологія», Серія «Медицина») № 5(39) 2024 994 and intermediates necessary for cellular respiration and ATP synthesis.Moreover, thiamine's involvement in the pentose phosphate pathway (PPP) through its role in transketolase activity influences nucleotide synthesis and antioxidant defense mechanisms.Additionally, thiamine is critical in neurotransmitter and myelin synthesis, both essential for signal transmission along nerves and synaptic plasticity.Thiamine deficiency disrupts these physiological processes, leading to the neurological symptoms characteristic of WKS.Despite its association with chronic alcoholism, WKS can occur in nonalcoholic populations, including individuals with malnutrition, gastrointestinal disorders, eating disorders, or other medical conditions that impair thiamine absorption and utilization.The diverse etiology and risk factors for WKS highlight the need for comprehensive approaches to its prevention, diagnosis, and management across various clinical settings and populations.