Crail-Melendez D, Atriano-Mendieta C, Carrillo-Meza R, Ramirez-Bermudez J
Department of Neuropsychiatry, National Institute of Neurology and Neurosurgery, Mexico City, Mexico.
Neurocase. 2013;19(1):22-6. doi: 10.1080/13554794.2011.654211. Epub 2012 Apr 12.
Thalamic dysfunction has been associated with schizophrenia and other psychotic disorders. We describe an adult patient with a lacunar infarct in the posterior region of the right thalamus exhibiting a paranoid schizophrenia-like psychosis as the only clinical manifestation. Neuropsychological assessment showed alterations in visuospatial memory and executive functions at follow up. This case highlights the role of information processing by the thalamus in the development of delusions. We suggest that dysfunction of the right mediodorsal and pulvinar thalamic nuclei disrupts both thalamic sensory processing and thalamo-prefrontal circuits mediating belief evaluation, leading to delusional beliefs.
丘脑功能障碍与精神分裂症及其他精神障碍有关。我们描述了一名成年患者，其右侧丘脑后部有腔隙性梗死，仅表现出偏执型精神分裂症样精神病这一临床表现。神经心理学评估显示，随访时该患者在视觉空间记忆和执行功能方面存在改变。该病例突出了丘脑信息处理在妄想形成中的作用。我们认为，右侧丘脑背内侧核和丘脑枕核功能障碍会破坏丘脑感觉处理以及介导信念评估的丘脑 - 前额叶回路，从而导致妄想信念。
