PT -期刊文章盟对Stockert盟——大学二年级生ia Hormig-Rauber AU - Max Wawrzyniak AU - Julian Klingbeil AU - Hans Ralf Schneider AU - Mandy Pirlich AU - Stefan Schob AU - Karl-Titus Hoffmann AU - Dorothee Saur TI - Involvement of Thalamocortical Networks in Patients With Poststroke Thalamic Aphasia AID - 10.1212/WNL.0000000000201488 DP - 2023 Jan 31 TA - Neurology PG - e485--e496 VI - 100 IP - 5 4099 - //www.ebmtp.com/content/100/5/e485.short 4100 - //www.ebmtp.com/content/100/5/e485.full SO - Neurology2023 Jan 31; 100 AB - Background and Objective Theories assume that thalamic stroke may cause aphasia because of dysfunction in connected cortical networks. This takes into account that brain functions are organized in distributed networks, and in turn, localized damage may result in a network disorder such as thalamic aphasia. With this study, we investigate whether the integration of the thalamus into specific thalamocortical networks underlies symptoms after thalamic stroke. We hypothesize that thalamic lesions in patients with language impairments are functionally connected to cortical networks for language and cognition.Methods We combined nonparametric lesion mapping methods in a retrospective cohort of patients with acute or subacute first-ever thalamic stroke. A relationship between lesion location and language impairments was assessed using nonparametric voxel-based lesion-symptom mapping. This method reveals regions more frequently damaged in patients with compared with those without a symptom of interest. To test whether these symptoms are linked to a common thalamocortical network, we additionally performed lesion-network-symptom mapping. This method uses normative connectome data from resting-state fMRI of healthy participants (n = 65) for functional connectivity analyses, with lesion sites serving as seeds. Resulting lesion-dependent network connectivity of patients with language impairments was compared with those with motor and sensory deficits as baseline.Results A total of 101 patients (mean [SD] age 64.1 [14.6] years, 57 left, 42 right, and 2 bilateral lesions) were included in the study. Voxel-based lesion-symptom mapping showed an association of language impairments with damage to left mediodorsal thalamic nucleus lesions. Lesion-network-symptom mapping revealed that language compared with sensory deficits were associated with higher normative lesion-dependent network connectivity to left frontotemporal language networks and bilateral prefrontal, insulo-opercular, midline cingular, and parietal domain-general networks. Lesions related to motor and sensory deficits showed higher lesion-dependent network connectivity within the sensorimotor network spanning prefrontal, precentral, and postcentral cortices.Discussion Thalamic aphasia relates to lesions in the left mediodorsal thalamic nucleus and to functionally connected left cortical language and bilateral cortical networks for cognitive control. This suggests that dysfunction in thalamocortical networks contributes to thalamic aphasia. We propose that inefficient integration between otherwise undamaged domain-general and language networks may cause thalamic aphasia.BA=Brodmann area; BOLD=blood-oxygenation-level dependent; DWI=diffusion-weighted imaging; FC=functional connectivity; FLAIR=fluid-attenuated inversion recovery; FWE=family-wise error; LNC=lesion-dependent network connectivity; LNSM=lesion-network-symptom mapping; MNI=Montreal Neurological Institute; ROI=region of interest; SPM12=Statistical Parametric Mapping, version 12; VLSM=voxel-based lesion-symptom mapping