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Subjective cognitive-affective status following thalamic stroke

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Abstract

Previous patient studies suggest that thalamic stroke may yield persistent deficits in several cognitive domains. At present, the subjective dimension and everyday relevance of these impairments is unclear, since many patients with thalamic stroke only show minor changes on physical examination. Here, we have studied subjective consequences of focal thalamic lesions. A sample of 68 patients with a history of ischemic thalamic stroke was examined by using established clinical self-report questionnaires assessing memory, attention, executive functions, emotional status and health-related quality of life. In order to control for general factors related to cerebrovascular disease, self-reports were compared to an age-matched group of 34 patients with a history of transient ischemic attack. Thalamic lesions were co-registered to an atlas of the human thalamus. Lesion overlap and subtraction analyses were used for lesion-to-symptom mapping. When both patient groups were compared, no significant differences were found for either questionnaire. However, when subgroups were compared, patients with infarctions involving the posterior thalamus showed significant emotional disturbances and elevated anxiety levels compared to patients with more anterior lesions. Our findings thus point to the existence of a persistent affective impairment associated with chronic lesions of the posterior thalamus. This syndrome may result from damage to connections between medial pulvinar and extra-thalamic regions involved in affective processing. Our findings suggest that the posterior thalamus may contribute significantly to the regulation of mood.

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Acknowledgments

This work was supported by the German Federal Ministry of Education and Research [grant no. 01GW0653 (Visuospatial Cognition)]. The authors wish to thank the patients for their kind cooperation with our study and Andrea Nest (Vivantes Klinikum Neukölln, Berlin), Hans Tepe and Rafael Poschmann (Charité – Campus Benjamin Franklin, Berlin) for generous technical support during patient recruitment.

Conflicts of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany

    Daniela Liebermann, Florian Ostendorf, Ute A. Kopp, Antje Kraft & Christoph J. Ploner

  2. Center for Stroke Research, Charité-Universitätsmedizin Berlin, Berlin, Germany

    Daniela Liebermann

  3. Berlin School of Mind and Brain, Berlin, Germany

    Florian Ostendorf

  4. Institute of Radiology, Charité-Universitätsmedizin Berlin, Berlin, Germany

    Georg Bohner

  5. Department of Neurology, Vivantes Klinikum Neukölln, Berlin, Germany

    Darius G. Nabavi

  6. Institute of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany

    Norbert Kathmann

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  1. Daniela Liebermann
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Correspondence to Christoph J. Ploner.

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415_2012_6635_MOESM1_ESM.tif

Self-report on cognitive-emotional domains in posterior affected and posterior intact thalamic patients. Blue colour indicates posterior thalamic patients (posterior affected, n=11), lilac colour denotes age-matched thalamic patients without posterior affection (thalamus age, n=11). All data are given as percent scores (mean±SEM). Abbreviations: Abil, MAC-S Ability scale; Freq, MAC-S Frequency scale; Glob, MAC-S Global scale; DEX, Dysexecutive questionnaire; Ment, FEDA scale 1 (Distractibility and deceleration in mental processes); Prac, FEDA scale 2 (Fatigue and slowing of practical activities); Drive, FEDA scale 3 (Drive); Depr, HADS-Depression subscale; Anx, HADS Anxiety subscale; PCS, SF-12 physical (TIFF 11,190 kb)

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Liebermann, D., Ostendorf, F., Kopp, U.A. et al. Subjective cognitive-affective status following thalamic stroke. J Neurol 260, 386–396 (2013). https://doi.org/10.1007/s00415-012-6635-y

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  • DOI: https://doi.org/10.1007/s00415-012-6635-y

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