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When levels fall too low, brain cells cannot generate enough energy to function properly. As a result, Korsakoff syndrome may develop. Korsakoff syndrome is most commonly caused by alcohol misuse, but can also be associated with AIDS, chronic infections, poor nutrition and certain other conditions.
Specifically in Alzheimer's disease, atrophy in the temporal lobe has been known to occur. As evidenced in trauma and seizures, phantosmia is strongly associated with this area; leading to its appearance in some Alzheimer's patients.