Loss of psychic self-activation with bithalamic infarction. Neurobehavioural, CT, MRI and SPECT correlates.

Details

Serval ID
serval:BIB_51D541A8238A
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Loss of psychic self-activation with bithalamic infarction. Neurobehavioural, CT, MRI and SPECT correlates.
Journal
Acta Neurologica Scandinavica
Author(s)
Bogousslavsky J., Regli F., Delaloye B., Delaloye-Bischof A., Assal G., Uske A.
ISSN
0001-6314
Publication state
Published
Issued date
05/1991
Peer-reviewed
Oui
Volume
83
Number
5
Pages
309-316
Language
english
Notes
Publication types: Case Reports ; Journal Article
Publication Status: ppublish
Abstract
Two patients with bilateral thalamo-mesencephalic infarct in the paramedian territory developed vertical gaze dysfunction and marked behavioural changes, in the absence of significant motor inability and formal neuropsychological impairment. While they were physically and emotionally active before stroke, they became apathetic, aspontaneous, indifferent, and seemed to have lost motor and affectic drive, as well as the need itself for any psychic activity. However, this mental and motor inertia was reversible when the patients were repeatedly stimulated by another person. This need for constant external programming, together with a lack of emotional reactivity, made the patients resemble robots. CT and MRI suggested involvement of the dorsomedial and midline nuclei of the thalamus, and SPECT showed remote frontomesial hypoperfusion. A disturbance of the striatal-ventral pallidal-thalamic-frontomesial limbic loop is suggested by previous reports of a similar "loss of psychic self-activation", "pure psychic akinesia", or "athymhormia" with bipallidal, bistriatal, or subcortical bifrontal lesions.
Keywords
Arousal/physiology, Cerebral Infarction/diagnosis, Cerebral Infarction/physiopathology, Delirium, Dementia, Amnestic, Cognitive Disorders/diagnosis, Delirium, Dementia, Amnestic, Cognitive Disorders/physiopathology, Dominance, Cerebral/physiology, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Motivation, Motor Activity/physiology, Neuropsychological Tests, Regional Blood Flow/physiology, Thalamus/blood supply, Tomography, Emission-Computed, Single-Photon, Tomography, X-Ray Computed
Pubmed
Web of science
Create date
10/04/2008 16:52
Last modification date
20/08/2019 14:07
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