630 Neurocognitive Disorders
brain imaging indicators may be seen over ma ny months. If the diso rder continues for an
extended period, persistent  should be specified. The give n substance and its use must be
known to be capable of causing the observed impairments (Criterion C). While nonspecific
decrements in a range of cognitive abilities can occur with nearly any substance of abuse
and a variety of medications, some patterns occur more frequently  with selected drug
classes. For example, NCD due to sedative, hypno tic, or anxiolytic drugs (e.g., benzodiaz-
epines, barbiturates) ma y show greater disturbances in memory than in other cognitive
functions. NCD induced by alcohol frequently  manifests with a co mbination of impair-
ments in executive-function and memory and learning domains. Th e temporal course of
the substance-induced NCD must be consistent  with that of use of the given substance
(Criterion D). In alcohol-induced amnestic confabulatory (Korsakoff ’s) NCD, the features
include prominent amnesia (severe difficulty learning new information with rapid forget-
ting) and a tendency to confabulate. These ma nifestations may co-occur with signs of thi-
amine encephalopathy (Wernicke’s encephalopathy) with associated features such as
nystagmus and ataxia. Ophthalmoplegia of Wernicke’s encephalopathy is typically charac-
terized by a lateral gaze paralysis.
In addition to or independent of the mo re common neurocognitive symptoms related
to methamphetamine use (e.g., difficulties wi th learning and memory; executive func-
tion), methamphetamine use can also be associat ed with evidence of vascular injury (e.g.,