Frequency and phenotype of thalamic aphasia.

Aged Aphasia / etiology Female Humans Language Magnetic Resonance Imaging Male Phenotype Speech Stroke Thalamus / diagnostic imaging
Aphasia Language Stroke Thalamus

Journal

Journal of neurology
ISSN: 1432-1459
Titre abrégé: J Neurol
Pays: Germany
ID NLM: 0423161

Informations de publication

Date de publication:
Jan 2022
Historique:
received: 02 03 2021
accepted: 01 06 2021
revised: 28 05 2021
pubmed: 9 6 2021
medline: 11 1 2022
entrez: 8 6 2021
Statut: ppublish

Résumé

Aphasia is a recognized presenting symptom of thalamic lesions. Little is known regarding its frequency and phenotype. We examined the frequency of thalamic aphasia following Isolated Acute unilateral ischemic Lesions in the Thalamus (IALT) with respect to lesion location. Furthermore, we characterized thalamic aphasia according to affected language domains and severity. Fifty-two patients with IALT were analyzed [44% female, median age: 73 years (IQR: 60-79)]. Lesion location was determined using 3-Tesla magnetic resonance imaging and categorized as anterior, posterior, paramedian or inferolateral. Standardized language assessment was performed using the validated Aphasia checklist (ACL) directly after symptom onset. Aphasia was defined as an ACL sum score of < 135 (range: 0-148). Of 52 patients, 23 (44%) fulfilled the ACL diagnostic criteria for aphasia, including nearly all lesion locations and both sides. The average ACL sum score was 132 ± 11 (range: 98-147). Aphasia was characterized by deficits within domains of complex understanding of speech and verbal fluency. Patients with left anterior IALT were most severely affected, having significantly lower ACL scores than all other patients (117 ± 13 vs. 135 ± 8; p < 0.001). In particular, aphasia in patients with left anterior IALT was characterized by significantly worse performance in the rating of verbal communication, verbal fluency, and naming (all p ≤ 0.001). Aphasia occurs in almost half of patients with focal thalamic lesions. Thalamic aphasia is not confined to one predefined thalamic lesion location, but language deficits are particularly pronounced in patients with left anterior IALT presenting with a distinct pattern.

Sections du résumé

BACKGROUND BACKGROUND
Aphasia is a recognized presenting symptom of thalamic lesions. Little is known regarding its frequency and phenotype. We examined the frequency of thalamic aphasia following Isolated Acute unilateral ischemic Lesions in the Thalamus (IALT) with respect to lesion location. Furthermore, we characterized thalamic aphasia according to affected language domains and severity.
METHODS METHODS
Fifty-two patients with IALT were analyzed [44% female, median age: 73 years (IQR: 60-79)]. Lesion location was determined using 3-Tesla magnetic resonance imaging and categorized as anterior, posterior, paramedian or inferolateral. Standardized language assessment was performed using the validated Aphasia checklist (ACL) directly after symptom onset. Aphasia was defined as an ACL sum score of < 135 (range: 0-148).
RESULTS RESULTS
Of 52 patients, 23 (44%) fulfilled the ACL diagnostic criteria for aphasia, including nearly all lesion locations and both sides. The average ACL sum score was 132 ± 11 (range: 98-147). Aphasia was characterized by deficits within domains of complex understanding of speech and verbal fluency. Patients with left anterior IALT were most severely affected, having significantly lower ACL scores than all other patients (117 ± 13 vs. 135 ± 8; p < 0.001). In particular, aphasia in patients with left anterior IALT was characterized by significantly worse performance in the rating of verbal communication, verbal fluency, and naming (all p ≤ 0.001).
CONCLUSION CONCLUSIONS
Aphasia occurs in almost half of patients with focal thalamic lesions. Thalamic aphasia is not confined to one predefined thalamic lesion location, but language deficits are particularly pronounced in patients with left anterior IALT presenting with a distinct pattern.

Identifiants

DOI: 10.1007/s00415-021-10640-4 PMID: 34100990 PMC: PMC8739316
pubmed: 34100990
doi: 10.1007/s00415-021-10640-4
pii: 10.1007/s00415-021-10640-4
pmc: PMC8739316
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

368-376

Informations de copyright

© 2021. The Author(s).

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Auteurs

Ida Rangus (I)

Department of Neurology with Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany. ida.rangus@charite.de.
ORCID: 0000-0001-9189-8941

Merve Fritsch (M)

Department of Psychiatry, Charité-Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany.
ORCID: 0000-0002-2855-0755

Matthias Endres (M)

Department of Neurology with Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany.
Center for Stroke Research Berlin, Berlin, Germany.
ExcellenceCluster NeuroCure, Berlin, Germany.
German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany.
German Centre for Cardiovascular Research (DZHK), Berlin, Germany.
ORCID: 0000-0001-6520-3720

Birgit Udke (B)

Department of Audiology and Phoniatrics, Charité-Universitätsmedizin Berlin, Berlin, Germany.

Christian H Nolte (CH)

Department of Neurology with Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany.
Center for Stroke Research Berlin, Berlin, Germany.
German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany.
German Centre for Cardiovascular Research (DZHK), Berlin, Germany.
ORCID: 0000-0001-5577-1775

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Frequency and phenotype of thalamic aphasia.
questionsmedicales.fr › États, signes et symptômes pathologiques › Signes et symptômes › Manifestations neurologiques › Troubles du langage › Troubles de la parole › Aphasie › Frequency and phenotype of thalamic aphasia.
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Frequency and phenotype of thalamic aphasia.
questionsmedicales.fr › Sciences de l'information › Langage › Frequency and phenotype of thalamic aphasia.
questionsmedicales.fr › Diagnostic › Techniques et procédures diagnostiques › Imagerie diagnostique › Tomographie › Imagerie par résonance magnétique › Frequency and phenotype of thalamic aphasia.
questionsmedicales.fr › Phénomènes génétiques › Phénotype › Frequency and phenotype of thalamic aphasia.
questionsmedicales.fr › Sciences de l'information › Langage › Arts du langage › Parole › Frequency and phenotype of thalamic aphasia.
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Angiopathies intracrâniennes › Accident vasculaire cérébral › Frequency and phenotype of thalamic aphasia.
questionsmedicales.fr › Système nerveux › Système nerveux central › Encéphale › Prosencéphale › Diencéphale › Thalamus › Frequency and phenotype of thalamic aphasia.