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Cerebrovascular disease
Neuroanatomy of a neurobehavioral disturbance in the left anterior thalamic infarction
  1. Yoshiyuki Nishio1,
  2. Mamoru Hashimoto2,
  3. Kazunari Ishii3,
  4. Etsuro Mori1
  1. 1Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University, Sendai, Japan
  2. 2Department of Psychiatry and Neuropathobiology, Kumamoto University, Kumamoto, Japan
  3. 3Department of Radiology, Kinki University, Sayama, Japan
  1. Correspondence to Dr Yoshiyuki Nishio, Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine; 2-1, Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan; nishiou{at}med.tohoku.ac.jp

Abstract

Background and purpose Cognitive and behavioural symptoms represent primary clinical manifestations of anterior thalamic infarcts (ATIs) in the tuberothalamic artery territory. The aim of the study is to understand the pathomechanism of cognitive and behavioural disturbances in left ATI (LATI).

Methods 6 patients with isolated LATIs were investigated using neuropsychological assessments, MRI stereotactic lesion localisation and positron emission tomography.

Results The patients were characterised clinically by verbal memory impairment, language disturbances dominated by anomia and word-finding difficulty and apathy. The ventral anterior nucleus (VA) proper, magnocellular VA (VAmc), ventral lateral anterior nucleus (VLa), ventral lateral posterior nucleus (VLp) and mammillothalamic tract were involved in all patients. Compared with healthy controls, the regional cerebral blood flow was lower in the thalamus, the dorsolateral, medial and orbital frontal lobes, the anterior temporal lobe, the inferior parietal lobule and the occipital lobe of the left hemisphere.

Conclusions The authors propose that the Papez circuit disruption at the mammillothalamic tract and possibly thalamomedial temporal disconnection at the VA region is responsible for memory impairment and that the thalamo-anterior temporal disconnection is associated with language disturbance in LATI, respectively.

  • Diencephalic amnesia
  • semantic
  • subcortical
  • thalamocortical
  • amnesia
  • cognition
  • MRI
  • PET
  • vascular dementia

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Footnotes

  • Funding This work was supported by Grants-in-Aid for dementia research from the MHLW Japan (22800).

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Hyogo Institute for Aging Brain and Cognitive Disorders.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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