Paramedian Thalamic Ischemic Infarction: A Retrospective Clinical Observation

Lin, Guoliang; Zhang, Xiong; Hu, Bei‐Lei; Zou, Ming; Chen, Songfang; Gong, Yuqiang; Cheng, Bihuan; He, Zelai

doi:10.1159/000458705

Cited by 11 publications

(12 citation statements)

References 12 publications

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“…Damage to the intralaminar thalamic nuclei, which receive a dense NA innervation ( Figs 3 – 6 , Table 3 ), is reckoned as one of the causes for the pathological loss of consciousness ( Castaigne et al . 1981 ; Lin et al . 2017 ).…”

Section: Discussionmentioning

confidence: 99%

Distribution of the Noradrenaline Innervation and Adrenoceptors in the Macaque Monkey Thalamus

et al. 2021

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Noradrenaline (NA) in the thalamus has important roles in physiological, pharmacological, and pathological neuromodulation. In this work, a complete characterization of NA axons and Alpha adrenoceptors distributions is provided. NA axons, revealed by immunohistochemistry against the synthesizing enzyme and the NA transporter, are present in all thalamic nuclei. The most densely innervated ones are the midline nuclei, intralaminar nuclei (paracentral and parafascicular), and the medial sector of the mediodorsal nucleus (MDm). The ventral motor nuclei and most somatosensory relay nuclei receive a moderate NA innervation. The pulvinar complex receives a heterogeneous innervation. The lateral geniculate nucleus (GL) has the lowest NA innervation. Alpha adrenoceptors were analyzed by in vitro quantitative autoradiography. Alpha-1 receptor densities are higher than Alpha-2 densities. Overall, axonal densities and Alpha adrenoceptor densities coincide; although some mismatches were identified. The nuclei with the highest Alpha-1 values are MDm, the parvocellular part of the ventral posterior medial nucleus, medial pulvinar, and midline nuclei. The nucleus with the lowest Alpha-1 receptor density is GL. Alpha-2 receptor densities are highest in the lateral dorsal, centromedian, medial and inferior pulvinar, and midline nuclei. These results suggest a role for NA in modulating thalamic involvement in consciousness, limbic, cognitive, and executive functions.

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Section: Discussionmentioning

confidence: 99%

Distribution of the Noradrenaline Innervation and Adrenoceptors in the Macaque Monkey Thalamus

et al. 2021

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“…Previous clinical and fundamental investigations on the implication of thalamic lesions on regards to arousal, led to contrasting results with either loss (3,4,55) or no changes in arousability (56,57). Here, we took advantage of the optical fibre technology for better temporal and spatial infarct resolution to investigate the functional consequences of IL Opto-STROKE.…”

Section: Histological Characterization Of Optical Mini-stroke (Opto-stroke) In Thalamic Regionsmentioning

confidence: 99%

Optical mini-stroke of thalamic networks impairs sleep stability, topography and cognition

Lenzi

Borsa

Czekus

et al. 2021

Preprint

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Modelling stroke in animals remains a challenge for translational research, especially for the infraction of small subcortical arteries. Using combined fibre optics and photothrombosis technologies, we developed a novel model of optically-induced infarcts (Opto-STROKE). Combining our model with electrophysiological recordings in freely-behaving mice, we studied early and late consequent patho-physiological changes in the dynamics of sleep-wake circuits and cognitive performance. Here, focusing on inducing Opto-STROKE lesions in the intralaminar thalamus (IL), which in humans cause severe impairments of arousal, cognition, and affective symptoms, our model recapitulated important deficits on sleep disorders presented in humans including arousal instability, concurrent to an augmented slow-wave activity and a reduction gamma power bands during wakefulness. Moreover, during NREM sleep, spindle density was decreased and topographically shifted to frontal cortices when compared to control animals. Remarkably, gamma power and spindle density were correlated with decreased pain threshold and impaired prefrontal cortex- dependent working memory in Opto-STROKE mice relative to controls. Collectively, our combined method influences both anatomical and functional outcomes of the classical stroke procedures and offers new insights on the fundamental role of the media thalamus as a hub for the regulation of both sleep-wake architecture and cognition.

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“…In 5 patients with bilateral paramedian infarction and 4 patients with unilateral paramedian infarction, coma, vertical eye movement impairment and memory impairment were detected. As a result, they reported that paramedian infarctions leads to coma, vertical eye movement impairment and memory impairment in both unilateral and bilateral groups [22]. In another study, it was reported that patients with paramedian infarction had hypersomnia, lack of daytime wakefulness and impaired night sleep stages [23].…”

Section: Discussionmentioning

confidence: 99%

Long term neurological sequela of isolated infarctions according to the topographic areas of thalamus

Pak¹,

Gürkan²,

Doğan³

et al. 2021

Turk J Med Sci

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Background/aim: Thalamus infarctions presented with various clinical findings are considered to be related to classical and variative infarction areas. In our study, we aimed to compare the sequela clinical findings of patients with isolated thalamus infarction according to anatomical areas.Methods: 70 patients diagnosed with isolated thalamus infarction in our clinic between 2010 and 2020 were included in the study. The infarction areas of the patients were divided into groups by the radiologist, including the variative areas to the classical areas using magnetic resonance imaging. Neurological examinations were performed and recorded. Sequela clinical findings of the groups were compared. Results:The mean age of all patients was 64.49 ± 13.75 (range between: 33-81) years, and the female ratio was 52.9% (n: 33). Inferolateral area infarction was detected most commonly. The most common complaints were sensory complaints (48.6%), speech disorders (20%), limb weakness (15.7%). There were no significant association between the neurological examination findings of classical and variative area infarctions of patients whose most common admission complaint is sensory deficits (p <0.05), and significant signs of cognitive impairment were detected in the anterior area compared to other areas (p<0.001). It can be considered that cognitive impairment we detected in the anterior area developed due to its associations. Conclusions:In our study where sequela findings were evaluated, the absence of a significant difference in neurological examination findings can be explained by the decline of many acute clinical findings over time.

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Paramedian Thalamic Ischemic Infarction: A Retrospective Clinical Observation

Cited by 11 publications

References 12 publications

Distribution of the Noradrenaline Innervation and Adrenoceptors in the Macaque Monkey Thalamus

Distribution of the Noradrenaline Innervation and Adrenoceptors in the Macaque Monkey Thalamus

Optical mini-stroke of thalamic networks impairs sleep stability, topography and cognition

Long term neurological sequela of isolated infarctions according to the topographic areas of thalamus

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