Diaschisis after thalamic stroke: a comparison of metabolic and structural changes in a patient with amnesic syndrome
Diaschisis after thalamic stroke: a comparison of metabolic and structural changes in a patient with amnesic syndrome
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DOI：
10.1111/j.1600-0404.2007.00851.x
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发表时间：
2007-01-01
影响因子：
3.5
通讯作者：
Fladby, T.
中科院分区：
文献类型：
--
作者：
Stenset, V.;Grambaite, R.;Fladby, T.
引言我们提出一个病人与左前内侧丘脑病变与健忘综合征。患者接受了神经心理学测试、脑脊液（CSF）分析、磁共振成像（MRI）[T2、flair和扩散张量成像（DTI）]和[18 F]-2-氟-脱氧-D-葡萄糖正电子发射断层扫描（FDG-PET），以评估丘脑病变对皮质功能的间接影响。病例报告一位67岁的右撇子妇女因为记忆和注意力问题被一所大学的记忆单位录取。神经心理学测试显示，情节记忆、语义记忆和工作记忆功能障碍。一般智力功能和注意力都得到了保留。MRI显示左半球前内侧丘脑病变。FDG-PET显示左半球额叶、顶叶和颞叶的摄取减少。选择白色物质中的感兴趣区域（ROI），并比较左右半球。与右半球相比，代表丘脑-皮质连接的ROI中的各向异性分数（FA）在左半球降低。结论包括前核和背内侧核在内的神经网络对大脑皮层负责记忆过程的区域的活动有重要影响。影像学结果表明，丘脑梗死后皮质神经联系不能的地区对应于受影响的地区丘脑皮质纤维损失与FA测量。
Introduction We present a patient with a left anteromedial thalamic lesion with an amnesic syndrome. The patient underwent neuropsychological testing, cerebrospinal fluid (CSF) analyses, magnetic resonance imaging (MRI) [T2, flair, and diffusion tensor imaging (DTI)] and [18F]-2-fluoro-deoxy-D-glucose positron emission tomography (FDG-PET) to assess indirect effects of thalamic lesions on cortical function. Case report A 67-year-old right-handed woman was admitted to a university-based memory unit because of memory and concentration problems. Neuropsychological testing revealed dysfunction of episodic memory, semantic memory and working memory. General intellectual function and attention capacity were preserved. MRI revealed an anteromedial thalamic lesion in the left hemisphere. FDG-PET showed decreased uptake in the frontal, parietal and temporal lobes of the left hemisphere. Regions of interest (ROI) in white matter were selected and left and right hemispheres were compared. Fractional anisotropy (FA) in ROI representing thalamo-cortical connections were decreased in the left hemisphere when compared with the right. Conclusion The results show the importance of a network that include the anterior and dorsomedian nuclei, which influence the activity in areas of the cortex responsible for memory processes. The imaging findings suggest that areas of cortical diaschisis after thalamic infarction correspond to areas affected by thalamo-cortical fibre loss as measured with FA.