Excitotoxic Cytopathology, Progression, and Reversibility of Thiamine Deficiency-induced Diencephalic Lesions

Department of Psychology, San Diego State University, San Diego, California, United States
Journal of Neuropathology and Experimental Neurology (Impact Factor: 3.8). 04/1995; 54(2):255-67. DOI: 10.1097/00005072-199503000-00012
Source: PubMed


The present study examined the cytopathological changes within diencephalon of a rat model of Wernicke's encephalopathy and determined whether administration of thiamine at various intervals after onset of neurological signs can arrest or reverse the cytopathological process. Electron microscopic examination of the brains from animals sacrificed at four progressively severe stages of pyrithiamine-induced thiamine deficiency (PTD) revealed neurocytopathological changes identical to those that have been described in glutamate-induced excitotoxic lesions. These degenerative changes occurred in gelatinosus (Ge) and anteroventral ventrolateral (AVVL) nuclei at an early symptomatic stage and in the ventroposterolateral (VPL), ventroposteromedial (VPM), and ventrolateral (VL) nuclei at slightly later stages of PTD. Light microscopic evaluation of separate groups of PTD rats administered thiamine at each of the same four neurologic stages and allowed to recover for 1 week demonstrated that thiamine treatment is more effective when administered at earlier stages. However, Ge, AVVL, and VPL nuclei sustain severe damage even when thiamine is administered prior to acute neurologic signs. Furthermore, pathologic changes in the mammillary and several midline intralaminar nuclei begin after thiamine administration and reinstitution of thiamine-replete diet to animals in more severe stages of thiamine deficiency. These and other recent findings suggest that excitotoxic and possibly apoptotic mechanisms may mediate neuronal degeneration in the PTD rat model of Wernicke's encephalopathy, and that multiple factors conducive to excitotoxicity may act in concert to produce this syndrome.

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    • "The neuroanatomical damage seen after PTD treatment is most likely due to glutamate excitotoxicity and/or ischemia [53, 74]. It has been well documented that glutamate excitotoxicity is responsible for thalamic lesions in the PTD model of WKS [75, 76] and cholinergic neurons are particularly sensitive to glutamate excitotoxicity. In particular, the differential susceptibility of cholinergic populations to oxidative stress depends on the ratio of acetyl-CoA energy producing and ACh synthesizing capacities [79]. "
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    ABSTRACT: Nutritional deficiency can cause, mainly in chronic alcoholic subjects, the Wernicke encephalopathy and its chronic neurological sequela, the Wernicke-Korsakoff syndrome (WKS). Long-term chronic ethanol abuse results in hippocampal and cortical cell loss. Thiamine deficiency also alters principally hippocampal- and frontal cortical-dependent neurochemistry; moreover in WKS patients, important pathological damage to the diencephalon can occur. In fact, the amnesic syndrome typical for WKS is mainly due to the damage in the diencephalic-hippocampal circuitry, including thalamic nuclei and mammillary bodies. The loss of cholinergic cells in the basal forebrain region results in decreased cholinergic input to the hippocampus and the cortex and reduced choline acetyltransferase and acetylcholinesterase activities and function, as well as in acetylcholine receptor downregulation within these brain regions. In this narrative review, we will focus on the neurochemical, neuroanatomical, and neuropsychological studies shedding light on the effects of thiamine deficiency in experimental models and in humans.
    The Scientific World Journal 10/2013; 2013:309143. DOI:10.1155/2013/309143 · 1.73 Impact Factor
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    • "Pyrithiamine induced thiamin deficiency (PTD) in the rat is a well validated experimental model to study the pathophysiology of human Wernicke encephalopathy where the histological lesions generally mirror those seen in the human disorder. If rats are allowed to progress through a severe bout of thiamin deficiency, they develop lesions in the anterior and midline thalamus as well as the mammillary bodies (Zhang et al., 1995; Pfefferbaum et al., 2007). Furthermore, these animals show impaired memory function (Langlais and Savage, 1995) and older animals demonstrate greater susceptibility to brain damage (Pitkin and Savage, 2001). "
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    ABSTRACT: Although the neuropathology of Korsakoff's syndrome (KS) was first described well over a century ago and the characteristic brain pathology does not pose a diagnostic challenge to pathologists, there is still controversy over the neuroanatomical substrate of the distinctive memory impairment in these patients. Cohort studies of KS suggest a central role for the mammillary bodies and mediodorsal thalamus, and quantitative studies suggest additional damage to the anterior thalamus is required. Rare cases of KS caused by pathologies other than those of nutritional origin provide support for the role of the anterior thalamus and mammillary bodies. Taken together the evidence to date shows that damage to the thalamus and hypothalamus is required, in particular the anterior thalamic nucleus and the medial mammillary nucleus of the hypothalamus. As these nuclei form part of wider memory circuits, damage to the inter-connecting white matter tracts can also result in a similar deficit as direct damage to the nuclei. Although these nuclei and their connections appear to be the primary site of damage, input from other brain regions within the circuits, such as the frontal cortex and hippocampus, or more distant regions, including the cerebellum and amygdala, may have a modulatory role on memory function. Further studies to confirm the precise site(s) and extend of brain damage necessary for the memory impairment of KS are required.
    Neuropsychology Review 04/2012; 22(2):72-80. DOI:10.1007/s11065-012-9195-0 · 4.59 Impact Factor
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    • "There is little evidence for persistent behavioral impairments if rats are treated with thiamine prior to experiencing seizures (Pitkin and Savage 2001). At the early acute stage (EAS) of the PTD model, degenerative changes occur in the gelatinosus and anteroventral ventrolateral nuclei of the thalamus, both of which undergo rapid neuronal loss (see Zhang et al. 1995). Within 1 to 2 h following seizure onset, the brains of PTD-treated rodents exhibit lesions in the ventral and posterior nuclear groups of the thalamus that are characterized by severe neuronal loss and pale neuropil. "
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    ABSTRACT: Investigation of the amnesic disorder Korsakoff Syndrome (KS) has been vital in elucidating the critical brain regions involved in learning and memory. Although the thalamus and mammillary bodies are the primary sites of neuropathology in KS, functional deactivation of the hippocampus and certain cortical regions also contributes to the chronic cognitive dysfunction reported in KS. The rodent pyrithiamine-induced thiamine deficiency (PTD) model has been used to study the extent of hippocampal and cortical neuroadaptations in KS. In the PTD model, the hippocampus, frontal and retrosplenial cortical regions display loss of cholinergic innervation, decreases in behaviorally stimulated acetylcholine release and reductions in neurotrophins. While PTD treatment results in significant impairment in measures of spatial learning and memory, other cognitive processes are left intact and may be recruited to improve cognitive outcome. In addition, behavioral recovery can be stimulated in the PTD model by increasing acetylcholine levels in the medial septum, hippocampus and frontal cortex, but not in the retrosplenial cortex. These data indicate that although the hippocampus and frontal cortex are involved in the pathogenesis of KS, these regions retain neuroplasticity and may be critical targets for improving cognitive outcome in KS.
    Neuropsychology Review 04/2012; 22(2):195-209. DOI:10.1007/s11065-012-9194-1 · 4.59 Impact Factor
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