TY - JOUR
T1 - Vascular dementia with left thalamic infarction
T2 - Neuropsychological and behavioral implications suggested by involvement of the thalamic nucleus and the remote effect on cerebral cortex. The Osaki-Tajiri project
AU - Meguro, Kenichi
AU - Akanuma, Kyoko
AU - Ouchi, Yoshitaka
AU - Meguro, Mitsue
AU - Nakamura, Kei
AU - Yamaguchi, Satoshi
PY - 2013/7/30
Y1 - 2013/7/30
N2 - Vascular dementia (VaD) is a condition whereby decreased cerebral perfusion causes cognitive deterioration. We hypothesized that lesions of the anterior nucleus (AN) including the mammillo-thalamic tract cause a decline in the recollection of past episodes/events, and that the left thalamic infarction can cause frontal dysfunction through the "diaschisis." We investigated 18 VaD cases with only left thalamic infarction. 99mTc-ECD single photon emission computed tomography (SPECT) was used to assess regional cerebral blood flow (CBF). To test the first hypothesis, the scores on the Cognitive Abilities Screening Instrument (CASI) domain Recent memory or the rating on the Clinical Dementia Rating (CDR) domain Memory were analyzed. To test the second hypothesis, we selected the six regions of interest that correlated with the two measures, i.e., word fluency and/or depressive state, as assessed with the Geriatric Depression Scale (GDS). We found that all patients had amnesia, especially in the AN group, six of the eight patients had scores of 1+ on the CDR Memory scale, and all but one disclosed the CASI domain Recent memory impairment. There were significant correlations between the left anterior cingulate CBF and word fluency scores, and between the right rectal gyrus CBF and GDS scores. We suggest that these observations are due to a remote effect of the thalamic lesion.
AB - Vascular dementia (VaD) is a condition whereby decreased cerebral perfusion causes cognitive deterioration. We hypothesized that lesions of the anterior nucleus (AN) including the mammillo-thalamic tract cause a decline in the recollection of past episodes/events, and that the left thalamic infarction can cause frontal dysfunction through the "diaschisis." We investigated 18 VaD cases with only left thalamic infarction. 99mTc-ECD single photon emission computed tomography (SPECT) was used to assess regional cerebral blood flow (CBF). To test the first hypothesis, the scores on the Cognitive Abilities Screening Instrument (CASI) domain Recent memory or the rating on the Clinical Dementia Rating (CDR) domain Memory were analyzed. To test the second hypothesis, we selected the six regions of interest that correlated with the two measures, i.e., word fluency and/or depressive state, as assessed with the Geriatric Depression Scale (GDS). We found that all patients had amnesia, especially in the AN group, six of the eight patients had scores of 1+ on the CDR Memory scale, and all but one disclosed the CASI domain Recent memory impairment. There were significant correlations between the left anterior cingulate CBF and word fluency scores, and between the right rectal gyrus CBF and GDS scores. We suggest that these observations are due to a remote effect of the thalamic lesion.
KW - Depressive state
KW - Single photon emission computed tomography (SPECT)
KW - Thalamus
KW - Three-Dimensional Stereotaxic Surface Projection (3D-SSP)
KW - Vascular dementia
KW - Word fluency
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U2 - 10.1016/j.pscychresns.2012.12.004
DO - 10.1016/j.pscychresns.2012.12.004
M3 - Article
C2 - 23693088
AN - SCOPUS:84878372649
VL - 213
SP - 56
EP - 62
JO - Psychiatry Research - Neuroimaging
JF - Psychiatry Research - Neuroimaging
SN - 0925-4927
IS - 1
ER -