Disorders of Smell, Taste, and Food Intake in a Patient With a Dorsomedial Thalamic Infarct

Rousseaux, M.; Müller, P; Gahide, I.; Mottin, Y; Romon, Monique

doi:10.1161/01.str.27.12.2328

Cited by 69 publications

(38 citation statements)

References 13 publications

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“…In rodents, ablation of this structure impairs olfactory discrimination learning (Eichenbaum et al, 1980;Slotnick and Kaneko, 1981;Staubli et al, 1987;McBride and Slotnick, 1997), particularly for odors that were unfamiliar or difficult to associate (Eichenbaum et al, 1980), and these deficits are overcome only after extensive training (Staubli et al, 1987). In humans, lesions of the medial thalamus have been associated with odor discrimination impairments (Potter and Butters, 1980) as well as defects in the perception of odor valence (Rousseaux et al, 1996). Notwithstanding the functional complexity of MD thalamus, our results suggest a novel way to unify this body of work: a disruption of sensory attention may best explain the olfactory behavioral impairments documented in thalamus-lesioned animals and humans.…”

Section: Discussionmentioning

confidence: 99%

Attention to Odor Modulates Thalamocortical Connectivity in the Human Brain

Plailly¹,

Howard²,

Gitelman³

et al. 2008

J. Neurosci.

196

153

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It is widely assumed that the thalamus is functionally irrelevant for the sense of smell. Although animal studies suggest that the mediodorsal (MD) thalamus links primary olfactory (piriform) cortex to olfactory neocortical projection sites in orbitofrontal cortex (OFC), this transthalamic route is regarded to be inconsequential, particularly compared with a direct monosynaptic pathway linking piriform cortex and OFC. In this study, we combined functional magnetic resonance imaging with novel effective connectivity techniques to measure attention-dependent network coherence within direct (nonthalamic) and indirect (transthalamic) olfactory pathways. Human subjects were presented with (or without) an odor and with (or without) a tone, while selectively attending to either modality. Attention to odor significantly modulated neural coupling within the indirect pathway, strengthening MD thalamus-OFC connectivity. Critically, these effects were modality specific (odor Ͼ tone attention), directionally sensitive (forward Ͼ backward connections), and selective to route (indirect Ͼ direct pathway). Our findings support the idea that the human transthalamic pathway is an active modulatory target of olfactory attention. The results imply that olfaction, like all other sensory modalities, requires a thalamic relay, if only to consciously analyze a smell.

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Section: Discussionmentioning

confidence: 99%

Attention to Odor Modulates Thalamocortical Connectivity in the Human Brain

Plailly¹,

Howard²,

Gitelman³

et al. 2008

J. Neurosci.

196

153

View full text Add to dashboard Cite

show abstract

“…These findings have generated the view that, in olfaction, the thalamus may subserve higher-order processing (Eichenbaum et al, 1980;Slotnick and Kaneko, 1981;Slotnick and Risser, 1990). Consistent with this view, single-patient case studies suggested that thalamic lesions may spare detection but impair both discrimination (Potter and Butters, 1980) and hedonic judgments of odors (Rousseaux et al, 1996;Asai et al, 2008). In turn, a comprehensive brain imaging study found a thalamic role in olfactory attention (Plailly et al, 2008).…”

Section: Introductionmentioning

confidence: 93%

Spared and Impaired Olfactory Abilities after Thalamic Lesions

Sela¹,

Sacher²,

Serfaty³

et al. 2009

J. Neurosci.

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Olfactory information reaches olfactory cortex without a thalamic relay. This neuroanatomical substrate has combined with functional findings to suggest that, in olfaction, the typical thalamic role in sensory processing has shifted to the olfactory bulb or olfactory cortex. With this in mind, we set out to ask whether the thalamus at all plays a significant functional role in human olfaction. We tested olfactory function in 17 patients with unilateral focal thalamic lesions and in age-matched healthy controls. We found that thalamic lesions did not significantly influence olfactory detection but significantly impaired olfactory identification, and only right lesions altered olfactory hedonics by reducing the pleasantness of pleasant odors. An auditory control revealed that this shift in pleasantness was olfactory specific. These olfactory impairments were evident in explicit measures of perception, as well as in patterns of sniffing. Whereas healthy subjects modulated their sniffs in accordance with odorant content, thalamic patients did not. We conclude that, although the thalamus is not in the path of olfactory information from periphery to cortex, it nevertheless plays a significant functional role in human olfaction.

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“…8,26,27 In a cohort of stroke survivors, 28 24% experienced weight loss of greater than ~6.6 lbs (3 kg). Those identified as having eating difficulties were more likely to experience significant weight loss at 4-month follow-up.…”

Section: Weight Loss and Malnutritionmentioning

confidence: 99%

“…Impaired taste perception can result from lesions in several locations including the pons, insular cortices, and specific thalamic nuclei. [1][2][3][4][5][6][7][8][9][10] Several case reports have detailed altered taste as a result of isolated pontine lesions [2][3][4][5][6]10 as well as both isolated right and left insular lesions. 11,12 Deficits including ageusia (inability to taste), hypogeusia (decreased ability to taste), and dysgeusia (distorted ability to taste) have also been described.…”

mentioning

confidence: 99%

Altered Taste and Stroke: A Case Report and Literature Review

Dutta

2013

Top Stroke Rehabil

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Patients with altered taste perception following stroke are at risk for malnutrition and associated complications that may impede recovery and adversely affect quality of life. Such deficits often induce and exacerbate depressive symptomatology, which can further hamper recovery. It is important for clinicians and rehabilitation specialists to monitor stroke patients for altered taste perception so that this issue can be addressed. The authors present the case of a patient who experienced an isolated ischemic infarct affecting a primary cortical taste area. This case is unusual in that the isolated injury allowed the patient to remain relatively intact cognitively and functionally, and thus able to accurately describe her taste-related deficits. The case is further used to describe the relevant neurological taste pathways and review potential taste-related therapies.

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Disorders of Smell, Taste, and Food Intake in a Patient With a Dorsomedial Thalamic Infarct

Abstract: This case suggests that the dorsomedial thalamus may play a role in the hedonic perception of food, thus affecting short-term regulation of food intake, and may possibly have a role in the long-term control of body weight.

Cited by 69 publications

References 13 publications

Attention to Odor Modulates Thalamocortical Connectivity in the Human Brain

Attention to Odor Modulates Thalamocortical Connectivity in the Human Brain

Spared and Impaired Olfactory Abilities after Thalamic Lesions

Altered Taste and Stroke: A Case Report and Literature Review

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