Akinetic mutism: disconnection of frontal-subcortical circuits.
Akinetic mutism may result from anterior cingulate lesions or a disconnection of the limbic connections projecting from the cingulate through subcortical circuits. Based on nonhuman primate primate tracer studies, ventral pallidal lesions should disrupt the anterior cingulate frontal-subcortical circuit. A patient developed a rigid akinetic mute state caused by bilateral lesions of the globus pallidus interna with ventral extension. The anatomic basis of the patient's clinical findings support a similarity in frontal-subcortical anatomy between humans and nonhuman primates. Isolated pallidal lesions are rare. Future studies should document whether ventral extension below the anterior commissure is associated with a loss of motivation.
Mega
M S
MS
Department of Neurology, UCLA School of Medicine 90095-1769, USA.
Cohenour
R C
RC
D000368:Aged; D000405:Akinetic Mutism / Q000175:diagnosis / Q000209:etiology*; D001037:Aphasia / Q000209:etiology; D001284:Atrophy / Q000150:complications / Q000473:pathology; D005260:Female; D005625:Frontal Lobe / Q000473:pathology*; D005917:Globus Pallidus / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D009042:Motivation; D009434:Neural Pathways; D009483:Neuropsychological Tests