Altered Food Preference after Cortical Infarction: Korean Style

Kim, Jong Seung; Choi, S-Mi

doi:10.1159/000047774

Cited by 24 publications

(13 citation statements)

References 15 publications

(16 reference statements)

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“…Patients included in this study, however, had lesions extending beyond the insular cortex into the adjacent white matter, and limited details were provided regarding the topography of each insular lesion. Changes in eating behavior were reported by Kim et al [2], who encountered four patients with altered food preferences after middle cerebral artery infarction. Two of these patients, whose strokes involved the insula, also demonstrated impulsive behaviors.…”

mentioning

confidence: 66%

Social-emotional dysfunction after isolated right anterior insular infarction

et al. 2011

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Recent human functional neuroimaging studies have demonstrated intrinsic functional connectivity among the anterior insula (AI), anterior cingulate cortex (ACC), amygdala, thalamus, hypothalamus, striatum, and brainstem. These regions have been collectively referred to as the ''salience network'' due to their consistent activation by diverse, homeostatically relevant stimuli that carry emotional weight [8]. Evidence supporting a role for the salience network in social-emotional function comes from patients with behavioral variant frontotemporal dementia (bvFTD), an early age-of-onset neurodegenerative disorder that produces dramatic changes in social behavior [6,7]. The right ventral anterior insula, a focus of degeneration in bvFTD, has been proposed as a key hub within this network [9], and functional imaging studies reveal consistent activation of this region during social-emotional processing [3]. The consequences of isolated, destructive anterior insula lesions, however, have not been reported. Here, we describe a 66-year-old woman who developed an abrupt change in social behavior after isolated right ventral anterior insular infarction.A 66-year-old right-handed woman presented with sudden onset of slurred speech. She had suffered from hypertension for 3 years and had a history of ischemic stroke involving the left parietal cortex, manifested by a subjective dysarthria one-and-a-half years earlier, from which she completely recovered during the follow-up period. She had been taking an antiplatelet agent and had no history of alcohol use or smoking. She had no previous history of depression or other psychiatric illness. Neurological examination revealed mild dysarthria and left central facial weakness. Diffusion-weighted magnetic resonance imaging (MRI) on the same day of admission revealed focal hyperintensity in the ventral anterior portion of the right insular cortex (Fig. 1a, b), with a corresponding hypointensity on the apparent diffusion coefficient map. T2-weighted imaging showed no abnormalities. Single photon emission computed tomography (SPECT) performed 2 days post-stroke showed hypoperfusion in the same region (Fig. 1c), but also in distributed right anterior brain structures (temporal pole, striatum, lateral frontal cortex) with known connectivity to the AI. Magnetic Electronic supplementary material The online version of this article (

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confidence: 66%

Social-emotional dysfunction after isolated right anterior insular infarction

et al. 2011

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“…In this study, ipsilateral [12][13][14]16], contralateral [2,7], and bilateral taste disorders [3,[14][15][16][17] were observed for lesional sites located above the midbrain. In previous reports, it was hypothesized that the pathway crosses and ascends contralaterally above the midbrain [7] or that the taste information from the right side of the tongue projects to the left insular cortex via the right insular cortex [14].…”

Section: Laterality Of the Gustatory Centermentioning

confidence: 99%

“…The other 25 cases were previously reported in the literature from 1983 to 2008 [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. The three cases we have already reported [2] were not included in these patients.…”

Section: Subjectsmentioning

confidence: 99%

“…In fact, the incidence of central taste disorders is very low with clinically defined taste disorders observed in 1.7% of patients [1]. As mentioned above, the central gustatory pathway is likely to branch and bilaterally ascend higher than the midbrain; however, cases with taste disorders caused by a unilateral lesion above the midbrain have been reported [2,7,[12][13][14]16]. It has been reported that two-thirds of nerve fibers ascending from the PBN ascend ipsilaterally and the remaining one-third ascend contralaterally in rats [42].…”

Section: Central Gustatory Pathwaymentioning

confidence: 99%

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Clinical study of central taste disorders and discussion of the central gustatory pathway

et al. 2011

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The aim of this work is to examine the clinical findings of patients with taste disorders due to central lesions and also to study the central gustatory pathway in humans. We conducted a retrospective review of 13 patients with central taste disorders that visited Nihon University Itabashi Hospital. An additional 25 cases with central taste disorders previously reported in the literature were assessed in the study. We examined 38 patients with taste disorders due to central lesions. The sites of the central lesions and their frequencies, the laterality of taste disorders relative to the central lesions, and prognosis of taste disorders were studied. We identified the following taste-related regions in the central nervous system: the medulla, pons, midbrain, thalamus, internal capsule, putamen, corona radiata, and cerebral cortex. As for the laterality of the taste disorders, we observed more ipsilateral cases for lesions located from the medulla to the pons. We observed ipsilateral, contralateral, and bilateral cases for lesions located above the midbrain, but bilateral cases were more frequently detected. Taste disorders of 80% of the patients improved by 24 weeks. The prognoses of central taste disorders appeared to be good. We identified eight central regions supposed to be relate to taste disorders. From the laterality of the taste disorders relative to the central lesions, it was suggested that the central gustatory pathway ascends ipsilaterally from the medulla to the pons, branches at the upper pons, and then ascends bilaterally from the midbrain to the cerebral cortex.

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“…Affected patients may report changes in food preferences 21 and find certain foods less palatable, leading to unintentional weight loss [22][23][24] and decreased energy level. Many patients report avoiding social activities because of loss of enjoyment in dining out and other food-related group activities.…”

Section: Consequences Of Altered Tastementioning

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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Altered Food Preference after Cortical Infarction: Korean Style

Cited by 24 publications

References 15 publications

Social-emotional dysfunction after isolated right anterior insular infarction

Social-emotional dysfunction after isolated right anterior insular infarction

Clinical study of central taste disorders and discussion of the central gustatory pathway

Altered Taste and Stroke: A Case Report and Literature Review

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