Pepin E P, Auray-Pepin L
Memory Clinic, Centre Hospitalier de Lachine, PQ, Canada.
Neurology. 1993 Apr;43(4):733-41. doi: 10.1212/wnl.43.4.733.
We report three cases with unilateral thalamic ischemic lesions that resulted in lasting material-specific memory impairments and concomitant selective frontal lobe-related cognitive deficits. In two cases the lesions were limited to the left thalamus, and in the third the right thalamus was involved. These deficits were associated with ipsilateral diencephalic, striatal, and dorsolateral prefrontal hypoperfusion. The damage implicated the ventral anterior nucleus, the mamillothalamic tract, and the rostroventral internal medullary lamina. These findings suggest that medial thalamic damage involving the ventral and rostral sector of the dorsal thalamus will concurrently affect functionally and neurally distinct limbodiencephalic pathways and diencephalic connections with the frontal cortex. A review of the neuropsychological and neuroimaging findings from previously reported cases with vascular lesions of the thalamus further supports this contention. The presence of frontal lobe-related cognitive deficits, though not obligatorily related to the memory problems, may contribute to some aspects of the memory deficits and affect the nature of the memory disorder observed in some cases with diencephalic amnesia.
我们报告了三例单侧丘脑缺血性病变的病例，这些病变导致了持久的物质特异性记忆障碍以及伴随的与额叶相关的选择性认知缺陷。其中两例病变局限于左侧丘脑，第三例右侧丘脑受累。这些缺陷与同侧间脑、纹状体和背外侧前额叶灌注不足有关。损伤累及腹前核、乳头丘脑束和嘴腹侧内髓板。这些发现表明，涉及背侧丘脑腹侧和嘴侧部分的内侧丘脑损伤会同时影响功能和神经上不同的边缘丘脑通路以及丘脑与额叶皮质的连接。对先前报道的丘脑血管病变病例的神经心理学和神经影像学研究结果进行回顾，进一步支持了这一观点。与额叶相关的认知缺陷的存在，虽然不一定与记忆问题相关，但可能在某些方面导致记忆缺陷，并影响在一些间脑失忆症病例中观察到的记忆障碍的性质。
