Effects of thalamic stroke on energy metabolism of the cerebral cortex: a positron tomography study in man

Positron emission tomography was used to study the effects of unilateral vascular thalamic lesions on cortical oxygen and glucose utilization in 10 patients. There was significant ipsilateral cortex hypometabolism in 9 of the 10 patients, affecting the whole cortical mantle diffusely. The only patie...

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Bibliographic Details
Published in:Brain (London, England : 1878) England : 1878), 1986-12, Vol.109 (6), p.1243-1259
Main Authors: BARON, J. C, D'ANTONA, R, PANTANO, P, SERDARU, M, SAMSON, Y, BOUSSER, M. G
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Cerebral Cortex - diagnostic imaging
Cerebral Cortex - metabolism
Cerebrovascular Disorders - metabolism
Deoxyglucose - analogs & derivatives
Female
Fluorodeoxyglucose F18
Glucose - metabolism
Humans
Male
Medical sciences
Middle Aged
Neurology
Oxygen Consumption
Thalamus - blood supply
Tomography, Emission-Computed
Vascular diseases and vascular malformations of the nervous system
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Summary:Positron emission tomography was used to study the effects of unilateral vascular thalamic lesions on cortical oxygen and glucose utilization in 10 patients. There was significant ipsilateral cortex hypometabolism in 9 of the 10 patients, affecting the whole cortical mantle diffusely. The only patient spared was free of neuropsychological deficit at the time of positron emission tomography. In 4 patients, the magnitude of ipsilateral cortical hypometabolism was significantly less at a follow-up PET study, when neuropsychological function had improved. When taken together, the 14 studies showed a significant tendency for the hypometabolism to improve with time after clinical onset. These data suggest that the ipsilateral cortical hypometabolism results from damage to the thalamocortical connections and reflect either loss of nonspecific activating afferences or a degenerative deafferentation-deafferentation process, or both. Its links with the concept of diaschisis are suggested by its tendency to recover. A causal relationship between cortical hypometabolism and neuropsychological deficit, however, although strongly suggested, cannot be firmly established from the present data.
ISSN:0006-8950
1460-2156
DOI:10.1093/brain/109.6.1243