When a person struggles with alcohol use disorder for a long time, they are at risk of developing several chronic conditions. One of these is colloquially referred to as wet brain, a type of dementia or cognitive impairment caused by a lack of thiamine, or vitamin B1. Wet brain is actually a combination of two related conditions: Wernicke encephalopathy and Korsakoff’s syndrome (more extreme forms are called Korsakoff’s psychosis). The overall medical condition is called Wernicke-Korsakoff syndrome.
Most people consume enough thiamine to prevent the development of this condition. However, people who struggle with alcohol use disorder may focus on consuming alcohol instead of eating a balanced diet, with whole grains and lean proteins. In other cases, alcohol can upset the stomach and the person may experience loss of appetite, or vomiting, which can reduce sources of thiamine. The liver stores some thiamine, although not very much, and damage to the liver from long-term alcohol abuse can prevent storage and release of this vitamin nutrient into the body.
Wet brain can progress in a specific pattern, or both Wernicke encephalopathy and Korsakoff’s syndrome can develop together. Sometimes, Korsakoff’s syndrome develops first. However, the typical pattern that constitutes wet brain is the development of Wernicke encephalopathy followed by Korsakoff’s psychosis. Among people who develop wet brain, 20 percent experience progression of symptoms until death; 10 percent spontaneously recovery with little or no medical intervention; and 70 percent do not die from the condition but require long-term care.