Frontal Lobe Dysfunction Following Infarction of the Left-Sided Medial Thalamus

Sandson, Thomas A.; Daffner, Kirk R.; Carvalho, Paulo A.; Mesulam, M-Marsel

doi:10.1001/archneur.1991.00530240106031

Cited by 94 publications

(52 citation statements)

References 34 publications

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“…The contribution of the medial frontal cortex to normal TMTB performance had already been suggested by case reports of patients with damage to this region 24 or to its subcortical connections 25,26 . These individuals easily lose track of the alternating response pattern.…”

Section: Discussionmentioning

confidence: 74%

The cerebral correlates of set-shifting: an fMRI study of the trail making test

Moll¹,

Oliveira‐Souza

Tovar‐Moll³

et al. 2002

Arq. Neuro-Psiquiatr.

222

145

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-The trail making test (TMT) pertains to a family of tests that tap the ability to alternate between cognitive categories. However, the value of the TMT as a localizing instrument remains elusive. Here we report the results of a functional magnetic resonance imaging (fMRI) study of a verbal adaptation of the TMT (vTMT). The vTMT takes advantage of the set-shifting properties of the TMT and, at the same time, minimizes the visuospatial and visuomotor components of the written TMT. Whole brain BOLD fMRI was performed during the alternating execution of vTMTA and vTMTB in seven normal adults with more than 12 years of formal education. Brain activation related to the set-shifting component of vTMTB was investigated by comparing performance on vTMTB with vTMTA, a simple counting task. There was a marked asymmetry of activation in favor of the left hemisphere, most notably in dorsolateral prefrontal cortex (BA 6 lateral, 44 and 46) and supplementary motor area/cingulate sulcus (BA 6 medial and 32). The intraparietal sulcus (BA 7 and 39) was bilaterally activated. These findings are in line with clinico-anatomic and functional neuroimaging data that point to a critical role of the dorsolateral and medial prefrontal cortices as well as the intraparietal sulci in the regulation of cognitive flexibility, intention, and the covert execution of saccades/anti-saccades. Many commonly used neuropsychological paradigms, such as the Stroop, Wisconsin Card Sorting, and go -no go tasks, share some patterns of cerebral activation with the TMT.KEY WORDS: trail making, functional MRI, executive function, prefrontal cortex, intraparietal sulcus, cognitive switching. Correlatos cerebrais da flexibilidade cognitiva: RM funcional do teste das trilhasRESUMO -O Teste de trilhas (TT) pertence a uma família de testes que aferem a capacidade de alternar entre categorias cognitivas. Não obstante, o valor de localização do TT permanece obscuro. Neste estudo, relatamos a análise de um estudo de uma adaptação verbal do TT (TTv) com ressonância magnética funcional (RMf). O TTv realça a propriedade de mudança de categorias do TT convencional (escrito) ao mesmo tempo em que minimiza seus componentes visuoespaciais e visuomotores. O cérebro inteiro foi estudado pela técnica BOLD durante a execução alternante do TTvA e TTvB em sete adultos normais com mais de 12 anos de escolaridade. A ativação cerebral relacionada ao componente de alternância cognitiva da Parte B foi investigada comparandose o desempenho no TTvB e no TTvA. Observamos acentuada assimetria de ativação a favor do hemisfério esquerdo, especificamente no córtex frontal dorsolateral (áreas 6 lateral, 44 e 46) e área motora suplementar/ sulco do cíngulo (área 6 medial e 32). O sulco intraparietal (áreas 7 e 39) foi ativado bilateralmente. Esses achados estão de acordo com dados clínico-anatômicos e de imagem funcional que apontam para o papel crítico do córtex prefrontal dorsolateral e medial, bem como do sulco intraparietal, na regulação da flexibilidade cognitiva, dos mecanismos...

show abstract

Section: Discussionmentioning

confidence: 74%

The cerebral correlates of set-shifting: an fMRI study of the trail making test

Moll¹,

Oliveira‐Souza

Tovar‐Moll³

et al. 2002

Arq. Neuro-Psiquiatr.

222

145

View full text Add to dashboard Cite

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“…33 Our patients' speaking difficulties may have been labeled dysphasia simply because the lesion was located in the left hemisphere, because only 4 of these 9 NLSSDI cases were located in the areas associated with dysphasia, such as the thalamus or the caudate nucleus. The higher frequency of leukoaraiosis and asymptomatic infarcts in the NLSSDI patients may also have contributed to the appearance of cortical symptoms; when the brain is already lesioned by leukoaraiosis or prior asymptomatic infarction, a small deep infarct possibly elicits more extensive functional disturbances than those caused by the small deep infarct alone.…”

mentioning

confidence: 92%

What causes false clinical prediction of small deep infarcts?

Lodder

Bamford

Kappelle

et al. 1994

Stroke

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Background and Purpose Our goal was to identify factors that play a role in false clinical diagnosis of small deep infarcts.Methods In 350 prospectively registered patients with a first supratentorial ischemic stroke, we clinically differentiated between lacunar and nonlacunar syndromes. Using computed tomography (CT), we distinguished small deep and territorial infarcts and also recorded leukoaraiosis and asymptomatic infarcts. Degree of initial handicap, potential source of cardioembolic stroke, and hypertension were also noted.Results One hundred forty-seven patients had a lacunar and 203 a nonlacunar syndrome. Forty-two (12%) had a lesion visualized by CT that was compatible with a recent infarct but was considered inappropriate for the clinical syndrome: nineteen had a nonlacunar syndrome but a small deep infarct, and 23 had a lacunar syndrome but a territorial infarct. Patients with a nonlacunar syndrome but a small deep infarct were more severely disabled (a modified Rankin scale rating of 5) (odds ratio [OR]

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“…Furthermore, in view of the dense, reciprocal interconnections between the MD and mPFC (Krettek and Price 1977;Groenewegen 1988;Price 1992, 1993;Taber et al 2004) it might be predicted that the MD functions in concert with the prefrontal cortex to enable associative recognition and recency judgments selectively. This prediction is supported indirectly by some of the parallel effects of MD lesions and prefrontal lesions on memory in humans (Milner and Petrides 1984;Sandson et al 1991; Van der Werf et al 2000), monkeys (Parker and Gaffan 1998), and rats (Hunt and Aggleton 1998;Dias and Aggleton 2000), but remains to be tested directly. Thus, the third goal of the present study was to use disconnection procedures that examine the interaction of MD and mPFC.…”

mentioning

confidence: 98%

The medial dorsal thalamic nucleus and the medial prefrontal cortex of the rat function together to support associative recognition and recency but not item recognition

et al. 2012

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In humans recognition memory deficits, a typical feature of diencephalic amnesia, have been tentatively linked to mediodorsal thalamic nucleus (MD) damage. Animal studies have occasionally investigated the role of the MD in single-item recognition, but have not systematically analyzed its involvement in other recognition memory processes. In Experiment 1 rats with bilateral excitotoxic lesions in the MD or the medial prefrontal cortex (mPFC) were tested in tasks that assessed single-item recognition (novel object preference), associative recognition memory (object-in-place), and recency discrimination (recency memory task). Experiment 2 examined the functional importance of the interactions between the MD and mPFC using disconnection techniques. Unilateral excitotoxic lesions were placed in both the MD and the mPFC in either the same (MD + mPFC Ipsi) or opposite hemispheres (MD + mPFC Contra group). Bilateral lesions in the MD or mPFC impaired object-in-place and recency memory tasks, but had no effect on novel object preference. In Experiment 2 the MD + mPFC Contra group was significantly impaired in the object-in-place and recency memory tasks compared with the MD + mPFC Ipsi group, but novel object preference was intact. Thus, connections between the MD and mPFC are critical for recognition memory when the discriminations involve associative or recency information. However, the rodent MD is not necessary for single-item recognition memory.

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Frontal Lobe Dysfunction Following Infarction of the Left-Sided Medial Thalamus

Cited by 94 publications

References 34 publications

The cerebral correlates of set-shifting: an fMRI study of the trail making test

The cerebral correlates of set-shifting: an fMRI study of the trail making test

What causes false clinical prediction of small deep infarcts?

The medial dorsal thalamic nucleus and the medial prefrontal cortex of the rat function together to support associative recognition and recency but not item recognition

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