Aphasie nach ischämischem Hirninfarkt im links anterioren Thalamus

ZUSAMMENFASSUNG

Aphasie ist ein typisches Symptom links fronto-temporaler Läsionen. Nicht selten werden aphasische Symptome jedoch auch nach subkortikalen Läsionen z. B. im Thalamus beschrieben. Als Ursache für aphasische Symptome bei Thalamusschädigungen vermutet man die Störung eines thalamo-kortikalen Sprachnetzwerkes. Die Rolle des Thalamus in Sprachfunktionen wird in einer Rekrutierung sprachrelevanter, kortikaler Areale im Sinne einer Monitorfunktion vermutet. Wir berichten über einen 72-jährigen Patienten, der nach einem isolierten, links-anterioren Thalamusinfarkt eine expressiv betonte Aphasie gezeigt hat, und geben einen Überblick zu pathophysiologischen Konzepten.

Abstract

Aphasia is a language disturbance typically associated with left fronto-temporal lesions. However, aphasic symptoms can also be seen after subcortical lesions, for example in the thalamus. Thalamic aphasia is thought to occur after disruption of a thalamo-cortical language networks. The thalamus is considered to act as a monitor, engaging specific cortical areas need for language functions. We report on a 72-year old male patient who presented with aphasia following a left-anterior ischemic stroke of the thalamus and present a review of the relevant literature.

• Literatur

• 1 Henseler I, Regenbrecht F, Obrig H. Lesion correlates of patholinguistic profiles in chronic aphasia: comparisons of syndrome-, modality- and symptom-level assessment. Brain 2014; 137 Pt 3 918-30
• 2 Dronkers NF, Plaisant O, Iba-Zizen MT. et al Paul Broca’s historic cases: high resolution MR imaging of the brains of Leborgne and Lelong. Brain 2007; 130 Pt 5 1432-41
• 3 Poeppel D, Emmorey K, Hickok G. et al Towards a new neurobiology of language. J Neurosci 2012; 32 (41) 14125-31
• 4 Murdoch BE. Subcortical brain mechanisms in speech and language. Folia Phoniatr Logop 2001; 53 (05) 233-51
• 5 Saur D, Kreher BW, Schnell S. et al Ventral and dorsal pathways for language. Proc Natl Acad Sci U S A 2008; 105 (46) 18035-40
• 6 Kummerer D, Hartwigsen G. et al Damage to ventral and dorsal language pathways in acute aphasia. Brain 2013; 136 Pt 2 619-29
• 7 Osawa A, Maeshima S. Aphasia and unilateral spatial neglect due to acute thalamic hemorrhage: clinical correlations and outcomes. Neurol Sci 2016; 37 (04) 565-72
• 8 Smyth GS, Stern K. Tumors of the Thalamus – A ClinicoPathological Study. Brain 1938; 61: 339-74
• 9 Hernandez Jimenez JM. et al Thalamic bacterial abscess presenting with hemiparesis and expressive aphasia. IDCases 2018; 13: e00417
• 10 Crosson B. Thalamic mechanisms in language: a reconsideration based on recent findings and concepts. Brain Lang 2013; 126 (01) 73-88
• 11 De Witte L, Brouns R, Kavadias D. et al Cognitive, affective and behavioural disturbances following vascular thalamic lesions: a review. Cortex 2011; 47 (03) 273-319
• 12 Ojemann GA. Asymmetric function of the thalamus in man. Ann N Y Acad Sci 1977; 299: 380-96
• 13 Ehlen F, Schoenecker T, Kuhn AA. et al Differential effects of deep brain stimulation on verbal fluency. Brain Lang 2014; 134: 23-33
• 14 Bogousslavsky J, Miklossy J, Deruaz JP. et al Thalamic aphasia. Neurology 1988; 38 (10) 1662
• 15 Ford AA, Triplett W, Sudhyadhom A. et al Broca’s area and its striatal and thalamic connections: a diffusion-MRI tractography study. Front Neuroanat 2013; 7: 8
• 16 Kraut MA, Kremen S. et al Object activation in semantic memory from visual multimodal feature input. J Cogn Neurosci 2002; 14 (01) 37-47
• 17 Llano DA. Functional imaging of the thalamus in language. Brain Lang 2013; 126 (01) 62-72
• 18 Steriade M, Jones EG. Llin©*s, RR Thalamic oscillations and signaling. New York: Wiley; 1990
• 19 Colavito V, Tesoriero C, Wirtu AT. et al Limbic thalamus and state-dependent behavior: The paraventricular nucleus of the thalamic midline as a node in circadian timing and sleep/wake-regulatory networks. Neurosci Biobehav Rev 2015; 54: 3-17
• 20 McCormick DA, Bal T. Sleep and arousal: thalamocortical mechanisms. Annu Rev Neurosci 1997; 20: 185-215
• 21 Sherman SM. The thalamus is more than just a relay. Curr Opin Neurobiol 2007; 17 (04) 417-22
• 22 Timbie C, Barbas H. Pathways for Emotions: Specializations in the Amygdalar, Mediodorsal Thalamic, and Posterior Orbitofrontal Network. J Neurosci 2015; 35 (34) 11976-87
• 23 Nadeau SE, Crosson B. Subcortical aphasia. Brain Lang 1997; 58 (03) 355-402 discussion 18–23
• 24 Ojemann GA. Models of the brain organization for higher integrative functions derived with electrical stimulation techniques. Hum Neurobiol 1982; 1 (04) 243-9
• 25 Ullman MT. The declarative/procedural model of lexicon and grammar. J Psycholinguist Res 2001; 30 (01) 37-69
• 26 Alain C, Reinke K, McDonald KL. et al Left thalamo-cortical network implicated in successful speech separation and identification. Neuroimage 2005; 26 (02) 592-9
• 27 Assaf M, Calhoun VD. et al Neural correlates of the object-recall process in semantic memory. Psychiatry Res 2006; 147 2–3 115-26
• 28 Slotnick SD, Moo LR, Kraut MA. et al Interactions between thalamic and cortical rhythms during semantic memory recall in human. Proc Natl Acad Sci U S A 2002; 99 (09) 6440-3
• 29 Hillis AE. et al Variability in subcortical aphasia is due to variable sites of cortical hypoperfusion. Brain Lang 2004; 89 (03) 524-30
• 30 Sebastian R, Schein MG, Davis C. et al Aphasia or Neglect after Thalamic Stroke: The Various Ways They may be Related to Cortical Hypoperfusion. Front Neurol 2014; 5: 231
• 31 Stenset V, Grambaite R, Reinvang I. et al Diaschisis after thalamic stroke: a comparison of metabolic and structural changes in a patient with amnesic syndrome. Acta Neurol Scand Suppl 2007; 187: 68-71
• 32 Szelies B, Herholz K, Pawlik G. et al Widespread functional effects of discrete thalamic infarction. Arch Neurol 1991; 48 (02) 178-82
• 33 Wahl M, Marzinzik F. et al The human thalamus processes syntactic and semantic language violations. Neuron 2008; 59 (05) 695-707
• 34 Bell DS. Speech functions of the thalamus inferred from the effects of thalamotomy. Brain 1968; 91 (04) 619-38
• 35 Schmahmann JD. Vascular syndromes of the thalamus. Stroke 2003; 34 (09) 2264-78