Thalamic sensory strokes with and without pain: differences in lesion patterns in the ventral posterior thalamus

Krause, Thomas; Brunecker, Peter; Pittl, Sandra; Taskin, Birol; Laubisch, Dinah; Winter, Benjamin; Lentza, Malamati Eleni; Malzahn, Uwe; Villringer, Kersten; Villringer, Arno; Jungehülsing, Gerhard Jan

doi:10.1136/jnnp-2011-301936

Cited by 98 publications

(79 citation statements)

References 42 publications

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“…They provide quick feedback for behaviorally relevant stimuli [35] and monitor attention and/or distraction (reviewed by Pessoa et al [34]). Irreversible damage to the pulvinar nuclei was associated with visual neglect but also with post-stroke pain [36,37], which could explain why these results were gathered in a pain-paradigm. Functional changes in the pulvinar, as demonstrated in our study, might contribute to biased acquisition and processing of information, which has been described as important pathophysiological factor in MD [38].…”

Section: Discussionmentioning

confidence: 99%

The pulvinar nucleus and antidepressant treatment: dynamic modeling of antidepressant response and remission with ultra-high field functional MRI

et al. 2018

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Functional magnetic resonance imaging (fMRI) successfully disentangled neuronal pathophysiology of major depression (MD), but only a few fMRI studies have investigated correlates and predictors of remission. Moreover, most studies have used clinical outcome parameters from two time points, which do not optimally depict differential response times. Therefore, we aimed to detect neuronal correlates of response and remission in an antidepressant treatment study with 7 T fMRI, potentially harnessing advances in detection power and spatial specificity. Moreover, we modeled outcome parameters from multiple study visits during a 12-week antidepressant fMRI study in 26 acute (aMD) patients compared to 36 stable remitted (rMD) patients and 33 healthy control subjects (HC). During an electrical painful stimulation task, significantly higher baseline activity in aMD compared to HC and rMD in the medial thalamic nuclei of the pulvinar was detected (p = 0.004, FWE-corrected), which was reduced by treatment. Moreover, clinical response followed a sigmoid function with a plateau phase in the beginning, a rapid decline and a further plateau at treatment end. By modeling the dynamic speed of response with fMRI-data, perigenual anterior cingulate activity after treatment was significantly associated with antidepressant response (p < 0.001, FWE-corrected). Temporoparietal junction (TPJ) baseline activity significantly predicted non-remission after 2 antidepressant trials (p = 0.005, FWE-corrected). The results underline the importance of the medial thalamus, attention networks in MD and antidepressant treatment. Moreover, by using a sigmoid model, this study provides a novel method to analyze the dynamic nature of response and remission for future trials.

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Section: Discussionmentioning

confidence: 99%

The pulvinar nucleus and antidepressant treatment: dynamic modeling of antidepressant response and remission with ultra-high field functional MRI

et al. 2018

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“…The symptom onset and infarct location mimic those commonly observed in CPSP patients. 1,4,9,10 Overall, the model recapitulates some of the key-features of human CPSP, and can be useful in facilitating the investigation of CPSP pathophysiology and treatment.…”

Section: Discussionmentioning

confidence: 91%

“…Recently, two clinical reports linked CPSP to more posterior, inferior, and lateral thalamic infarcts, clustering at the ventral posterior thalamic nuclei. 9,10 These relay nuclei receive inputs from medial lemniscus, spinothalamic, and trigeminothalamic tracts, and project to the somatosensory cortex where noxious and non-painful, thermal, and mechanical stimuli are processed. We, therefore, targeted the ventral posterior thalamic complex by using stereotaxic microinjections of endothelin-1 to create highly focal ischemic lesions in rats.…”

Section: Introductionmentioning

confidence: 99%

Late-Onset Thermal Hypersensitivity after Focal Ischemic Thalamic Infarcts as a Model for Central Post-Stroke Pain in Rats

Blasi

Herisson

Wang

et al. 2015

J Cereb Blood Flow Metab

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Central post-stroke pain (CPSP) is a neuropathic pain syndrome that often develops in a delayed manner after thalamic stroke. Here, we describe a new model of CPSP by stereotaxic thalamic injection of endothelin-1. Stroke rats (n = 12), but not saline-injected controls (n = 12), developed a progressive, contralateral cutaneous thermal hyperalgesia over 4 weeks, without motor deficits. Lesions were highly focal and mainly affected the ventral posterior thalamic complex. Tchis model reproduces the infarct location and delayed hypersensitivity typical of CPSP, and may be useful to investigate its pathophysiology and test therapies targeting recovery and pain after thalamic stroke. INTRODUCTIONCentral post-stroke pain (CPSP) is a neuropathic pain syndrome characterized by constant or recurrent pain after central nervous system injury. 1 Central post-stroke pain can be triggered by either an ischemic or hemorrhagic infarct at any level of the spinothalamic pathway and its cortical projections often involving the thalamus. 2 Central post-stroke pain is frequently overlooked, and can be misdiagnosed as musculoskeletal pain resulting from paresis and/or muscle tone abnormalities. 3 Epidemiological data are scarce, probably because of the difficulty in interpreting the clinical signs and the variable symptom onset. Thus, CPSP is often perceived as a rare event. 4 However, the true incidence in stroke patients is as high as 8% to 11%. 5 The pathophysiology of CPSP is still poorly understood, and therapeutic options are limited in part owing to a lack of clinically relevant animal models. 6 For example, experimental CPSP models involving thalamic hemorrhage all show acute onset of the pain symptoms, 7,8 in contrast to the delayed onset of CPSP several weeks later in patients. 4 To address these shortcomings, we aimed to develop a new experimental model that better mimics the lateonset hypersensitivity seen in CPSP patients. Recently, two clinical reports linked CPSP to more posterior, inferior, and lateral thalamic infarcts, clustering at the ventral posterior thalamic nuclei. 9,10 These relay nuclei receive inputs from medial lemniscus, spinothalamic, and trigeminothalamic tracts, and project to the somatosensory cortex where noxious and non-painful, thermal, and mechanical stimuli are processed. We, therefore, targeted the ventral posterior thalamic complex by using stereotaxic microinjections of endothelin-1 to create highly focal ischemic lesions in rats.

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“…For our patient, the middle-to-posterior parts of the thalamus were affected, covering the centromedian, lateral posterior, pulvinar, and reticular nuclei. The lateral posterior nucleus is mainly involved in various sensory functions (Krause et al, 2012), whereas the other three nuclei play crucial roles in aphasia and attentional dysfunction. The centromedian nucleus plays an important role in arousal and attentional function and mediates cortical and basal ganglia activities through its afferents and efferents (Nanda, Galvan, Smith, & Wichmann, 2009;van der Werf, Witter, & Groenewegen, 2002).…”

Section: The Thalamus and Semantic Jargonmentioning

confidence: 99%

Attentional dysfunction and word-finding difficulties are related to semantic jargon after a thalamic lesion: a case report

Nakajima

Funayama

2017

Aphasiology

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Background: Although many case reports on neologistic jargon have been documented, reports on semantic jargon are extremely rare, suggesting that semantic jargon may occur more rarely than neologistic jargon. Aims: To investigate potential mechanisms underlying semantic jargon. Methods & Procedures:We describe a patient who presented with semantic jargon after a left thalamic hemorrhage that mainly affected the pulvinar, lateral posterior nucleus, centromedian nucleus, and reticular nucleus. She was followed for 8 years, during which the temporal changes in her linguistic and neuropsychological functions were investigated. Outcomes & Results: The patient's semantic jargon disappeared and selective attention improved in parallel. Word-finding deficits remained at the end of the observation period. Conclusions: Our observations of this patient suggest that a thalamic lesion can cause attentional and linguistic dysfunction that does not activate an intended word and its images and, conversely, fails to inactivate non-relevant words and associated images, resulting in semantic jargon.

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Thalamic sensory strokes with and without pain: differences in lesion patterns in the ventral posterior thalamus

Cited by 98 publications

References 42 publications

The pulvinar nucleus and antidepressant treatment: dynamic modeling of antidepressant response and remission with ultra-high field functional MRI

The pulvinar nucleus and antidepressant treatment: dynamic modeling of antidepressant response and remission with ultra-high field functional MRI

Late-Onset Thermal Hypersensitivity after Focal Ischemic Thalamic Infarcts as a Model for Central Post-Stroke Pain in Rats

Attentional dysfunction and word-finding difficulties are related to semantic jargon after a thalamic lesion: a case report

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