Skip to main content
PMC home page
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1994 Jan;57(1):27–34. doi: 10.1136/jnnp.57.1.27

Pure amnesia after unilateral left polar thalamic infarct: topographic and sequential neuropsychological and metabolic (PET) correlations.

S Clarke 1, G Assal 1, J Bogousslavsky 1, F Regli 1, D W Townsend 1, K L Leenders 1, S Blecic 1
PMCID: PMC485036  PMID: 8301301

Abstract

A 54-year-old patient who had an isolated small polar thalamic infarct and acute global amnesia with slight frontal type dysfunction but without other neurological dysfunction was studied. Memory improved partially within 8 months. At all stages the impairment was more severe for verbal than non-verbal memory. Autobiographic recollections and newly acquired information tended to be disorganised with respect to temporal order. Procedural memory was unaffected. Both emotional involvement and pleasure in reading were lost. On MRI, the infarct was limited to the left anterior thalamic nuclei and the adjacent mamillothalamic tract. The regional cerebral metabolic rate of glucose (measured with PET) was decreased on the left in the thalamus, amygdala, and posterior cingulate cortex 2 weeks after the infarct, and in the thalamus and posterior cingulate cortex 9 months later. These findings stress the specific role of the left anterior thalamic region in memory and confirm that longlasting amnesia from a thalamic lesion can occur without significant structural damage to the dorsomedial nucleus. Furthermore, they suggest that the anterior thalamic nuclei and possibly their connections with the posterior cingulate cortex play a role in emotional involvement linked to ipsilateral hemispheric functions.

Full text

PDF
27

Images in this article

28Image
on p.28
28Image
on p.28
29Image
on p.29

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barbizet J., Degos J. D., Louarn F., Nguyen J. P., Mas J. L. Amnésie par lésion ischémique bi-thalamique. Rev Neurol (Paris) 1981;137(6-7):415–424. [PubMed] [Google Scholar]
  2. Baron J. C., D'Antona R., Pantano P., Serdaru M., Samson Y., Bousser M. G. Effects of thalamic stroke on energy metabolism of the cerebral cortex. A positron tomography study in man. Brain. 1986 Dec;109(Pt 6):1243–1259. doi: 10.1093/brain/109.6.1243. [DOI] [PubMed] [Google Scholar]
  3. Bogousslavsky J., Ferrazzini M., Regli F., Assal G., Tanabe H., Delaloye-Bischof A. Manic delirium and frontal-like syndrome with paramedian infarction of the right thalamus. J Neurol Neurosurg Psychiatry. 1988 Jan;51(1):116–119. doi: 10.1136/jnnp.51.1.116. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Bogousslavsky J., Miklossy J., Deruaz J. P., Regli F., Assal G. Unilateral left paramedian infarction of thalamus and midbrain: a clinico-pathological study. J Neurol Neurosurg Psychiatry. 1986 Jun;49(6):686–694. doi: 10.1136/jnnp.49.6.686. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Bogousslavsky J., Regli F., Assal G. The syndrome of unilateral tuberothalamic artery territory infarction. Stroke. 1986 May-Jun;17(3):434–441. doi: 10.1161/01.str.17.3.434. [DOI] [PubMed] [Google Scholar]
  6. Bogousslavsky J., Regli F., Delaloye B., Delaloye-Bischof A., Assal G., Uske A. Loss of psychic self-activation with bithalamic infarction. Neurobehavioural, CT, MRI and SPECT correlates. Acta Neurol Scand. 1991 May;83(5):309–316. doi: 10.1111/j.1600-0404.1991.tb04708.x. [DOI] [PubMed] [Google Scholar]
  7. Bogousslavsky J., Regli F., Uske A. Thalamic infarcts: clinical syndromes, etiology, and prognosis. Neurology. 1988 Jun;38(6):837–848. doi: 10.1212/wnl.38.6.837. [DOI] [PubMed] [Google Scholar]
  8. Bowers D., Verfaellie M., Valenstein E., Heilman K. M. Impaired acquisition of temporal information in retrosplenial amnesia. Brain Cogn. 1988 Aug;8(1):47–66. doi: 10.1016/0278-2626(88)90038-3. [DOI] [PubMed] [Google Scholar]
  9. Castaigne P., Lhermitte F., Buge A., Escourolle R., Hauw J. J., Lyon-Caen O. Paramedian thalamic and midbrain infarct: clinical and neuropathological study. Ann Neurol. 1981 Aug;10(2):127–148. doi: 10.1002/ana.410100204. [DOI] [PubMed] [Google Scholar]
  10. De Renzi E., Faglioni P. Normative data and screening power of a shortened version of the Token Test. Cortex. 1978 Mar;14(1):41–49. doi: 10.1016/s0010-9452(78)80006-9. [DOI] [PubMed] [Google Scholar]
  11. Franck G., Salmon E., Sadzot B., van der Linden M. Etude hémodynamique et métabolique par tomographie a émission de positons d'un cas d'atteinte ischémique thalamo-capsulaire droite. Rev Neurol (Paris) 1986;142(4):475–479. [PubMed] [Google Scholar]
  12. Gentilini M., De Renzi E., Crisi G. Bilateral paramedian thalamic artery infarcts: report of eight cases. J Neurol Neurosurg Psychiatry. 1987 Jul;50(7):900–909. doi: 10.1136/jnnp.50.7.900. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Goldenberg G., Wimmer A., Maly J. Amnesic syndrome with a unilateral thalamic lesion: a case report. J Neurol. 1983;229(2):79–86. doi: 10.1007/BF00313445. [DOI] [PubMed] [Google Scholar]
  14. Gorelick P. B., Amico L. L., Ganellen R., Benevento L. A. Transient global amnesia and thalamic infarction. Neurology. 1988 Mar;38(3):496–499. doi: 10.1212/wnl.38.3.496. [DOI] [PubMed] [Google Scholar]
  15. Graff-Radford N. R., Eslinger P. J., Damasio A. R., Yamada T. Nonhemorrhagic infarction of the thalamus: behavioral, anatomic, and physiologic correlates. Neurology. 1984 Jan;34(1):14–23. doi: 10.1212/wnl.34.1.14. [DOI] [PubMed] [Google Scholar]
  16. Graff-Radford N. R., Tranel D., Van Hoesen G. W., Brandt J. P. Diencephalic amnesia. Brain. 1990 Feb;113(Pt 1):1–25. doi: 10.1093/brain/113.1.1. [DOI] [PubMed] [Google Scholar]
  17. Guberman A., Stuss D. The syndrome of bilateral paramedian thalamic infarction. Neurology. 1983 May;33(5):540–546. doi: 10.1212/wnl.33.5.540. [DOI] [PubMed] [Google Scholar]
  18. Hodges J. R., Oxbury S. M. Persistent memory impairment following transient global amnesia. J Clin Exp Neuropsychol. 1990 Dec;12(6):904–920. doi: 10.1080/01688639008401030. [DOI] [PubMed] [Google Scholar]
  19. Huppert F. A., Piercy M. Recognition memory in amnesic patients: effect of temporal context and familiarity of material. Cortex. 1976 Mar;12(1):3–20. doi: 10.1016/s0010-9452(76)80024-x. [DOI] [PubMed] [Google Scholar]
  20. Levasseur M., Baron J. C., Sette G., Legault-Demare F., Pappata S., Mauguière F., Benoit N., Tran Dinh S., Degos J. D., Laplane D. Brain energy metabolism in bilateral paramedian thalamic infarcts. A positron emission tomography study. Brain. 1992 Jun;115(Pt 3):795–807. doi: 10.1093/brain/115.3.795. [DOI] [PubMed] [Google Scholar]
  21. Markowitsch H. J. Diencephalic amnesia: a reorientation towards tracts? Brain Res. 1988 Dec;472(4):351–370. doi: 10.1016/0006-8993(88)91226-7. [DOI] [PubMed] [Google Scholar]
  22. McEntee W. J., Biber M. P., Perl D. P., Benson D. F. Diencephalic amnesia: a reappraisal. J Neurol Neurosurg Psychiatry. 1976 May;39(5):436–441. doi: 10.1136/jnnp.39.5.436. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Meudell P. R., Mayes A. R., Ostergaard A., Pickering A. Recency and frequency judgements in alcoholic amnesics and normal people with poor memory. Cortex. 1985 Dec;21(4):487–511. doi: 10.1016/s0010-9452(58)80001-5. [DOI] [PubMed] [Google Scholar]
  24. Michel D., Laurent B., Foyatier N., Blanc A., Portafaix M. Infarctus thalamique paramédian gauche. Etude de la mémoire et du langage. Rev Neurol (Paris) 1982;138(6-7):533–550. [PubMed] [Google Scholar]
  25. Milner B., Corsi P., Leonard G. Frontal-lobe contribution to recency judgements. Neuropsychologia. 1991;29(6):601–618. doi: 10.1016/0028-3932(91)90013-x. [DOI] [PubMed] [Google Scholar]
  26. Milner B. Interhemispheric differences in the localization of psychological processes in man. Br Med Bull. 1971 Sep;27(3):272–277. doi: 10.1093/oxfordjournals.bmb.a070866. [DOI] [PubMed] [Google Scholar]
  27. Percheron G. Les artères du thalamus humain. I.--Artère et territoire thalamiques polaires de l'artère communicante postérieure. Rev Neurol (Paris) 1976 May;132(5):297–307. [PubMed] [Google Scholar]
  28. Rondot P., de Recondo J., Davous P., Bathien N., Coignet A. Infarctus thalamique bilatéral avec mouvements anormaux et amnésie durable. Rev Neurol (Paris) 1986;142(4):398–405. [PubMed] [Google Scholar]
  29. Rousseaux M., Kassiotis P., Signoret J. L., Cabaret M., Petit H. Syndrome amnésique par infarctus restreint du thalamus antérieur droit. Rev Neurol (Paris) 1991;147(12):809–818. [PubMed] [Google Scholar]
  30. Shimamura A. P., Janowsky J. S., Squire L. R. Memory for the temporal order of events in patients with frontal lobe lesions and amnesic patients. Neuropsychologia. 1990;28(8):803–813. doi: 10.1016/0028-3932(90)90004-8. [DOI] [PubMed] [Google Scholar]
  31. Sokoloff L., Reivich M., Kennedy C., Des Rosiers M. H., Patlak C. S., Pettigrew K. D., Sakurada O., Shinohara M. The [14C]deoxyglucose method for the measurement of local cerebral glucose utilization: theory, procedure, and normal values in the conscious and anesthetized albino rat. J Neurochem. 1977 May;28(5):897–916. doi: 10.1111/j.1471-4159.1977.tb10649.x. [DOI] [PubMed] [Google Scholar]
  32. Speedie L. J., Heilman K. M. Amnestic disturbance following infarction of the left dorsomedial nucleus of the thalamus. Neuropsychologia. 1982;20(5):597–604. doi: 10.1016/0028-3932(82)90033-1. [DOI] [PubMed] [Google Scholar]
  33. Speedie L. J., Heilman K. M. Anterograde memory deficits for visuospatial material after infarction of the right thalamus. Arch Neurol. 1983 Mar;40(3):183–186. doi: 10.1001/archneur.1983.04050030077017. [DOI] [PubMed] [Google Scholar]
  34. Squire L. R., Moore R. Y. Dorsal thalamic lesion in a noted case of human memory dysfunction. Ann Neurol. 1979 Dec;6(6):503–506. doi: 10.1002/ana.410060607. [DOI] [PubMed] [Google Scholar]
  35. Tyler J. L., Strother S. C., Zatorre R. J., Alivisatos B., Worsley K. J., Diksic M., Yamamoto Y. L. Stability of regional cerebral glucose metabolism in the normal brain measured by positron emission tomography. J Nucl Med. 1988 May;29(5):631–642. [PubMed] [Google Scholar]
  36. Vighetto A., Confavreux C., Boisson D., Aimard G., Devic M. Paralysie de l'abaissement du regard et amnésie globale durables par lésion thalamo-sous-thalamique bilatérale. Rev Neurol (Paris) 1986;142(4):449–455. [PubMed] [Google Scholar]
  37. Warrington E. K., Weiskrantz L. Amnesia: a disconnection syndrome? Neuropsychologia. 1982;20(3):233–248. doi: 10.1016/0028-3932(82)90099-9. [DOI] [PubMed] [Google Scholar]
  38. Winocur G., Oxbury S., Roberts R., Agnetti V., Davis C. Amnesia in a patient with bilateral lesions to the thalamus. Neuropsychologia. 1984;22(2):123–143. doi: 10.1016/0028-3932(84)90056-3. [DOI] [PubMed] [Google Scholar]
  39. Woods R. P., Cherry S. R., Mazziotta J. C. Rapid automated algorithm for aligning and reslicing PET images. J Comput Assist Tomogr. 1992 Jul-Aug;16(4):620–633. doi: 10.1097/00004728-199207000-00024. [DOI] [PubMed] [Google Scholar]
  40. von Cramon D. Y., Hebel N., Schuri U. A contribution to the anatomical basis of thalamic amnesia. Brain. 1985 Dec;108(Pt 4):993–1008. doi: 10.1093/brain/108.4.993. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES