{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T14:56:07Z","timestamp":1792508167604,"version":"4.5.0"},"reference-count":66,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,5,10]],"date-time":"2022-05-10T00:00:00Z","timestamp":1652140800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001803","name":"Charles Darwin University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001803","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alcoholism Clin &amp;amp; Exp Res"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The primary cause of Wernicke\u2013Korsakoff syndrome (WKS) is thiamine deficiency, and more than 90% of cases are reported in alcohol\u2010dependent patients. While observational studies show parenteral thiamine administration drastically reduced WKS\u2010related mortality, relevant treatment trials have never been conducted to determine the optimum thiamine dose.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Two double\u2010blind, parallel groups, randomized controlled trials (RCTs) were conducted to determine the optimal thiamine dose required for (1) the prevention of Wernicke's encephalopathy (WE), the acute phase of WKS, in asymptomatic but \u201cat\u2010risk\u201d alcohol misuse patients (Study 1) and (2) the treatment of WE in symptomatic alcohol misuse patients (Study 2). Each study had a dosage regimen comprising three parenteral thiamine doses that were allocated at a ratio of 1:1:1. Study 1: Asymptomatic At\u2010Risk patients (<jats:italic>N<\/jats:italic>\u00a0=\u00a0393) received either 100\u00a0mg daily, 100\u00a0mg thrice daily, or 300\u00a0mg thrice daily, for 3\u00a0days. Study 2: Symptomatic patients (<jats:italic>N<\/jats:italic>\u00a0=\u00a0127) received either 100\u00a0mg thrice daily, 300\u00a0mg thrice daily, or 500\u00a0mg thrice daily, for 5\u00a0days. Cognitive function was the primary outcome, assessed using the Rowland Universal Dementia Assessment Scale, two Cogstate subtests, and an adapted Story Memory Recall test. Secondary analyses examined differences in neurological function (ataxia, oculomotor abnormalities, and confusion) at follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>No significant differences were observed between any of the dosage conditions for either Study 1 or Study 2 on cognition or neurological functioning. This real\u2010world study found that having a clinically unwell target population with high comorbidity and multiple presentations, coupled with challenges in cross\u2010cultural assessment is likely to complicate RCT findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The results of this study showed no clear benefit of high dose thiamine over intermediate or lower doses of thiamine, over the time intervals examined, for the treatment and prevention of cognitive and neurological abnormalities related to WKS. Several study limitations temper the interpretation of these findings. Nevertheless, the absence of conclusive evidence for the superiority of high\u2010dose thiamine supports a recommendation for patient\u2010specific treatment, while ensuring that the potential impact of other biochemical factors (e.g., magnesium and other B vitamin deficiencies) are considered and corrected if necessary.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acer.14843","type":"journal-article","created":{"date-parts":[[2022,4,16]],"date-time":"2022-04-16T05:15:30Z","timestamp":1650086130000},"page":"1133-1147","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["What is the optimum thiamine dose to treat or prevent Wernicke's encephalopathy or Wernicke\u2013Korsakoff syndrome? Results of a randomized controlled trial"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7841-4751","authenticated-orcid":false,"given":"Kylie M.","family":"Dingwall","sequence":"first","affiliation":[{"name":"Menzies School of Health Research Charles Darwin University  Alice Springs Northern Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer F.","family":"Delima","sequence":"additional","affiliation":[{"name":"Alice Springs Hospital  Alice Springs Northern Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Binks","sequence":"additional","affiliation":[{"name":"Menzies School of Health Research Charles Darwin University  Darwin Northern Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Batey","sequence":"additional","affiliation":[{"name":"Alice Springs Hospital  Alice Springs Northern Territory 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