Development of akinetic mutism and hyperphagia after left thalamic and right hypothalamic lesions

Shinoda, Masaki; Tsugu, Atsushi; Oda, Shinya; Masuko, Akihiko; Yamaguchi, Tatsuya; Tsugane, Ryuichi; Sato, Osamu

doi:10.1007/bf00303578

Cited by 18 publications

(5 citation statements)

References 11 publications

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“…Besides these, the hypothalamus is subject to many different types of lesions, including developmental abnormalities (Rathke's cleft cysts, hamartoma), primary tumors of the central nervous system (hypothalamic glioma), systemic tumors affecting the brain, inflammatory and granulomatous diseases (sarcoidosis) and lesions arising from the surrounding structures (Loes et al, 1991;Saleem et al, 2007). Notably, modern neuroimaging techniques have revealed the presence of lesions and tumors causing structural abnormalities in the hypothalamus of patients with eating disorders (Shinoda et al, 1993;De Vile et al, 1995), and the precocious onset of puberty (Jung et al, 2005;Trivin et al, 2006). Magnetic resonance imaging is the technique of choice for evaluating the anatomy of the hypothalamus in vivo.…”

Section: Introductionmentioning

confidence: 99%

MRI atlas of the human hypothalamus

et al. 2012

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Gaining new insights into the anatomy of the human hypothalamus is crucial for the development of new treatment strategies involving functional stereotactic neurosurgery. Here, using anatomical comparisons between histology and magnetic resonance images of the human hypothalamus in the coronal plane, we show that discrete gray and white hypothalamic structures are consistently identifiable by MRI. Macroscopic and microscopic images were used to precisely annotate the MRI sequences realized in the coronal plane in twenty healthy volunteers. MRI was performed on a 1.5T scanner, using a protocol including T1-weighted 3D fast field echo, T1-weighted inversionrecovery, turbo spin echo and T2-weighted 2D fast field echo imaging. For each gray matter structure as well as for white matter bundles, the different MRI sequences were analyzed in comparison to each other. The anterior commissure and the fornix were often identifiable, while the mammillothalamic tract was more difficult to spot. Qualitative analyses showed that MRI could also highlight finer structures such as the paraventricular nucleus, the ventromedial nucleus of the hypothalamus and the infundibular (arcuate) nucleus, brain nuclei that play key roles in the regulation of food intake and energy homeostasis. The posterior hypothalamic area, a target for deep brain stimulation in the treatment of cluster headaches, was readily identified, as was the lateral hypothalamic area, which similar to the aforementioned hypothalamic nuclei, could be a putative target for deep brain stimulation in the treatment of obesity. Finally, each of the identified structures was mapped to Montreal Neurological Institute (MNI) space. Please find enclosed the revised version of our manuscript "MRI atlas of the human hypothalamus" which we have modified according to the minor comment made by the reviewer#3.We appreciated the careful and incisive evaluation of our data made by the reviewers throughout the reviewing process. We hope that the manuscript is now in suitable form for publication in Neuroimage.  New insights into the anatomy of the human hypothalamus  Specific 1.5T MRI sequences approach histological resolution within the hypothalamus  White matter bundles within the hypothalamus can be identified using 1.5T MRI  Hypothalamic gray structures can be identified using 1.5T MRI *4. HighlightsWe have revised our manuscript to address the minor point raised by reviewer 3.In the "Data analysis" paragraph of the materials and methods section it now reads: "Structures were identified visually based on our knowledge of specific landmarks obtained from anatomical-histological cross sections and with reference to previously published atlases (Swaab et al., 1993;Koutcherov et al., 2000Koutcherov et al., , 2004Koutcherov et al., 2007;Mai et al., 2008); the landmarks used, such as the optic tract, the floor of the diencephalon, the third ventricle, and the fornix, were readily and reliably identifiable in MR scans." AbstractGaining new insights into the anatomy of the hu...

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Section: Introductionmentioning

confidence: 99%

MRI atlas of the human hypothalamus

et al. 2012

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“…Another patient had lesions in the left intralaminar nucleus of the thalamus, right globus pallidus, and right dorsomedial nucleus of the hypothalamus and showed hyperphagic tendency, so hyperphagia might occur after destruction of the dorsomedial hypothalamic nucleus. 16) Our patient had hyperphagia due to a mass localized in the STN. The lesion and peritumoral edema also involved the upper part of the midbrain, posterior part of the thalamus, and the hypothalamus.…”

Section: Discussionmentioning

confidence: 76%

Subthalamic Nucleus Tumor Causing Hyperphagia-Case Report-

Barutça

Turğut

Meydan

et al. 2003

Neurol. Med. Chir.(Tokyo)

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A 42-year-old woman with locally advanced breast cancer developed headache just after completing adjuvant chemotherapy. Magnetic resonance imaging revealed a mass located in the left subthalamic nucleus (STN) and involving the posterior part of the thalamus and the hypothalamus. The patient refused a radiologically guided biopsy and gamma knife treatment was not financially possible. Palliative whole brain radiotherapy with hormonal therapy was administered. The patient gained 19 kg body weight during 4 months follow up because of hyperphagia. This solitary tumor, either a breast cancer metastasis or a primary tumor, involving the STN is extremely unusual.

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“…In accordance with the original description by Cairns [14] and later studies [12,13,22], Case 1 is a typical example of akinetic mutism: The patient is immobile, completely silent, and nonresponsive. Therefore, the mutism in this context is nonselective and part of a global lack of responsiveness.…”

Section: Resultsmentioning

confidence: 84%

“…A therapy session was videotaped 6 months after the accident ( Table 2). [2] Left cerebral hemisphere Traumatic [3] Left cerebral hemisphere Vascular [4] Left cerebral hemisphere Traumatic [5] Left cerebral hemisphere Traumatic [6] Right cerebral hemisphere Vascular [7] Perisylvian areas Epileptic [8] Perisylvian areas Epileptic [9] Opercula Infectious [ 10] Opercula Epileptic [ 11 ] Opercula Vascular [2] Diffuse Traumatic [12] Cortical/subcortical pathology Infectious [ 13] Thalamus Traumatic [ 14] Third ventricle Tumor [ 15] Basal ganglia Infectious [ 16] Brainstem Tumor surgery [ 17] Brainstem Tumor [18][19][20][21] Cerebellum Tumor surgery…”

Section: Case Reportsmentioning

confidence: 99%

The many faces of acquired neurologic mutism in childhood

Mourik

Dongen

Catsman‐Berrevoets

1996

Pediatric Neurology

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Acquired neurologic mutism in childhood is a complex phenomenon occurring in various neurologic conditions with different etiologies. We illustrate its clinical heterogeneity as reflected in a wide range of concomitant behavioral features by presenting 4 children with acquired neurologic mutism. Neuropsychologic examinations revealed differential patterns of defective or preserved phonation, orofaciai movements, communicative behavior, and linguistic functions. We propose that detailed neuropsychologic analysis contributes to descriptions of the evolution of the speech impairment beyond the mute phase and the long-term disability. A framework for the clinical evaluation of children is therefore presented.

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Development of akinetic mutism and hyperphagia after left thalamic and right hypothalamic lesions

Cited by 18 publications

References 11 publications

MRI atlas of the human hypothalamus

MRI atlas of the human hypothalamus

Subthalamic Nucleus Tumor Causing Hyperphagia-Case Report-

The many faces of acquired neurologic mutism in childhood

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