title: Neuroanatomy of a neurobehavioral disturbance in the left anterior thalamic infarction.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine; 2-1, Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan. nishiou@med.tohoku.ac.jp
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Nishio
authors.forename: Mamoru
authors.initials: M
authors.lastname: Hashimoto
authors.forename: Kazunari
authors.initials: K
authors.lastname: Ishii
authors.forename: Etsuro
authors.initials: E
authors.lastname: Mori
mesh_terms: D000368:Aged; D001931:Brain Mapping / Q000379:methods; D002544:Cerebral Infarction / Q000175:diagnosis* / Q000503:physiopathology; D003072:Cognition Disorders / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007806:Language Disorders / Q000175:diagnosis; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis; D008875:Middle Aged; D009445:Neuroanatomy; D009483:Neuropsychological Tests; D049268:Positron-Emission Tomography / Q000379:methods; D013788:Thalamus / Q000033:anatomy & histology / Q000503:physiopathology