Effects of thalamic infarction on the structural and functional connectivity of the ipsilesional primary somatosensory cortex

  • Li Chen
  • Tianyou LuoEmail author
  • Kangcheng Wang
  • Yong Zhang
  • Dandan Shi
  • Fajin Lv
  • Yang Li
  • Yongmei Li
  • Qi Li
  • Weidong Fang
  • Zhiwei Zhang
  • Juan Peng
  • Hanfeng Yang
Head and Neck



To identify regions causally influenced by thalamic stroke by measuring white matter integrity, cortical volume, and functional connectivity (FC) among patients with thalamic infarction (TI) and to determine the association between structural/functional alteration and somatosensory dysfunction.


Thirty-one cases with TI-induced somatosensory dysfunction and 32 healthy controls underwent magnetic resonance imaging scanning. We reconstructed the ipsilesional central thalamic radiation (CTR) and assessed its integrity using fractional anisotropy (FA), assessed S1 ipsilesional changes with cortical volume, and identified brain regions functionally connected to TI locations and regions without TI to examine the potential effects on somatosensory symptoms.


Compared with controls, TI patients showed decreased FA (F = 17.626, p < 0.001) in the ipsilesional CTR. TI patients exhibited significantly decreased cortical volume in the ipsilesional top S1. Both affected CTR (r = 0.460, p = 0.012) and S1 volume (r = 0.375, p = 0.049) were positively correlated with somatosensory impairment in TI patients. In controls, the TI region was highly functionally connected to atrophic top S1 and less connected to the adjacent middle S1 region in FC mapping. However, T1 patients demonstrated significantly increased FC between the ipsilesional thalamus and middle S1 area, which was adjacent to the atrophic S1 region.


TI induces remote changes in the S1, and this network of abnormality underlies the cause of the sensory deficits. However, our other finding that there is stronger connectivity in pathways adjacent to the damaged ones is likely responsible for at least some of the recovery of function.

Key Points

• TI led to secondary impairment in the CTR and cortical atrophy in the ipsilesional top of S1.

• TI patients exhibited significantly higher functional connectivity with the ipsilateral middle S1 which was mainly located within the non-atrophic area of S1.

• Our results provide neuroimaging markers for non-invasive treatment and predict somatosensory recovery.


Thalamus Stroke Magnetic resonance imaging 



Central thalamic radiation


Diffusion tensor imaging


Fractional anisotropy


Functional connectivity


Fugl-Meyer and Lindmark Assessment


Fugl-Meyer Assessment


Functional magnetic resonance imaging


Familywise error


Intracranial volume


Montreal Neurological Institute


Primary somatosensory cortex


Primary sensorimotor cortex


Thalamic infarction


Wallerian degeneration


White matter hyperintensities



This study was supported by the National Natural Science Foundation of China (81671666), the Doctoral Scientific Funds of North Sichuan Medical College (CBY16-QD04), Key Project Sichuan Provincial Department of Education (18ZA0211), Postgraduate Science Innovation Foundation of Chongqing (CYB16061), Fundamental Research Funds for the Central Universities (SWU1709569), and Chongqing Scientific and Technological Talents Program (kjxx2017011).

Compliance with ethical standards


The scientific guarantor of this publication is Tianyou Luo.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects in this study.

Ethical approval

Institutional Review Board approval was obtained.


• Prospective

• Case-control study

• Performed at one institution

Supplementary material

330_2019_6068_MOESM1_ESM.docx (4.5 mb)
ESM 1 (DOCX 4588 kb)


  1. 1.
    Kessner SS, Bingel U, Thomalla G (2016) Somatosensory deficits after stroke: a scoping review. Top Stroke Rehabil 23:136–146CrossRefPubMedGoogle Scholar
  2. 2.
    Leoni RF, Paiva FF, Kang BT et al (2012) Arterial spin labeling measurements of cerebral perfusion territories in experimental ischemic stroke. Transl Stroke Res 3:44–55CrossRefPubMedGoogle Scholar
  3. 3.
    Feigenson JS, McCarthy ML, Greenberg SD, Feigenson WD (1977) Factors influencing outcome and length of stay in a stroke rehabilitation unit. Part 2. Comparison of 318 screened and 248 unscreened patients. Stroke 8:657–662CrossRefPubMedGoogle Scholar
  4. 4.
    Meyer S, Kessner SS, Cheng B et al (2016) Voxel-based lesion-symptom mapping of stroke lesions underlying somatosensory deficits. Neuroimage Clin 10:257–266Google Scholar
  5. 5.
    Preusser S, Thiel SD, Rook C et al (2015) The perception of touch and the ventral somatosensory pathway. Brain 138:540–548Google Scholar
  6. 6.
    Kim JH, Greenspan JD, Coghill RC, Ohara S, Lenz FA (2007) Lesions limited to the human thalamic principal somatosensory nucleus (ventral caudal) are associated with loss of cold sensations and central pain. J Neurosci 27:4995–5004CrossRefPubMedGoogle Scholar
  7. 7.
    Kishi M, Sakakibara R, Nagao T, Terada H, Ogawa E (2009) Thalamic infarction disrupts spinothalamocortical projection to the mid-cingulate cortex and supplementary motor area. J Neurol Sci 281:104–107CrossRefPubMedGoogle Scholar
  8. 8.
    Ohara S, Lenz FA (2001) Reorganization of somatic sensory function in the human thalamus after stroke. Ann Neurol 50:800–803CrossRefPubMedGoogle Scholar
  9. 9.
    Staines WR, Black SE, Graham SJ, McIlroy WE (2002) Somatosensory gating and recovery from stroke involving the thalamus. Stroke 33:2642–2651CrossRefPubMedGoogle Scholar
  10. 10.
    Lee MY, Kim SH, Choi BY, Chang CH, Ahn SH, Jang SH (2012) Functional MRI finding by proprioceptive input in patients with thalamic hemorrhage. NeuroRehabilitation 30:131–136PubMedGoogle Scholar
  11. 11.
    Kunimatsu A, Aoki S, Masutani Y, Abe O, Mori H, Ohtomo K (2003) Three-dimensional white matter tractography by diffusion tensor imaging in ischaemic stroke involving the corticospinal tract. Neuroradiology 45:532–535CrossRefPubMedGoogle Scholar
  12. 12.
    Lee JS, Han MK, Kim SH, Kwon OK, Kim JH (2005) Fiber tracking by diffusion tensor imaging in corticospinal tract stroke: topographical correlation with clinical symptoms. Neuroimage 26:771–776CrossRefPubMedGoogle Scholar
  13. 13.
    Stinear CM, Barber PA, Smale PR, Coxon JP, Fleming MK, Byblow WD (2007) Functional potential in chronic stroke patients depends on corticospinal tract integrity. Brain 130:170–180CrossRefPubMedGoogle Scholar
  14. 14.
    Maguire EA, Gadian DG, Johnsrude IS, et al (2000) Navigation-related structural change in the hippocampi of taxi drivers. Proc Natl Acad Sci U S A 97:4398–4403Google Scholar
  15. 15.
    Seghier ML, Ramsden S, Lim L, Leff AP, Price CJ (2014) Gradual lesion expansion and brain shrinkage years after stroke. Stroke 45:877–879CrossRefPubMedGoogle Scholar
  16. 16.
    Barkhof F, Haller S, Rombouts SA (2014) Resting-state functional MR imaging: a new window to the brain. Radiology 272:29–49CrossRefPubMedGoogle Scholar
  17. 17.
    Liu J, Qin W, Zhang J, Zhang X, Yu C (2015) Enhanced interhemispheric functional connectivity compensates for anatomical connection damages in subcortical stroke. Stroke 46:1045–1051CrossRefPubMedGoogle Scholar
  18. 18.
    Dijkhuizen RM, Zaharchuk G, Otte WM (2014) Assessment and modulation of resting-state neural networks after stroke. Curr Opin Neurol 27:637–643CrossRefPubMedGoogle Scholar
  19. 19.
    Lindmark B, Hamrin E (1988) Evaluation of functional capacity after stroke as a basis for active intervention. Presentation of a modified chart for motor capacity assessment and its reliability. Scand J Rehabil Med 20:103–109PubMedGoogle Scholar
  20. 20.
    Fugl-Meyer AR, Jääskö L, Leyman I, Olsson S, Steglind S (1975) The post-stroke hemiplegic patient. 1. A method for evaluation of physical performance. Scand J Rehabil Med 7:13–31PubMedGoogle Scholar
  21. 21.
    Chen L, Luo T, Lv F et al (2016) Relationship between hippocampal subfield volumes and memory deficits in patients with thalamus infarction. Eur Arch Psychiatry Clin Neurosci 266:543–555CrossRefPubMedGoogle Scholar
  22. 22.
    Wilkinson M, Kane T, Wang R, Takahashi E (2016) Migration pathways of thalamic neurons and development of thalamocortical connections in humans revealed by diffusion MR tractography. Cereb Cortex 27:5683–5695Google Scholar
  23. 23.
    Wang D, Buckner RL, Liu H (2014) Functional specialization in the human brain estimated by intrinsic hemispheric interaction. J Neurosci 34:12341–12352CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Preacher KJ, Hayes AF (2008) Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behav Res Methods 40:879–891CrossRefPubMedGoogle Scholar
  25. 25.
    Behrens TE, Johansen-Berg H, Woolrich MW et al (2003) Non-invasive mapping of connections between human thalamus and cortex using diffusion imaging. Nat Neurosci 6:750–757Google Scholar
  26. 26.
    Silasi G, Murphy TH (2014) Stroke and the connectome: how connectivity guides therapeutic intervention. Neuron 83:1354–1368CrossRefPubMedGoogle Scholar
  27. 27.
    Yoon H, Kim J, Moon WJ et al (2017) Characterization of chronic axonal degeneration using diffusion tensor imaging in canine spinal cord injury: a quantitative analysis of diffusion tensor imaging parameters according to histopathological differences. J Neurotrauma 34:3041–3050Google Scholar
  28. 28.
    Cheng B, Schulz R, Bönstrup M et al (2015) Structural plasticity of remote cortical brain regions is determined by connectivity to the primary lesion in subcortical stroke. J Cereb Blood Flow Metab 35:1507–1514Google Scholar
  29. 29.
    Duering M, Righart R, Csanadi E et al (2012) Incident subcortical infarcts induce focal thinning in connected cortical regions. Neurology 79:2025–2028Google Scholar
  30. 30.
    Duering M, Righart R, Wollenweber FA, Zietemann V, Gesierich B, Dichgans M (2015) Acute infarcts cause focal thinning in remote cortex via degeneration of connecting fiber tracts. Neurology 84:1685–1692CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Zhang J, Meng L, Qin W, Liu N, Shi FD, Yu C (2014) Structural damage and functional reorganization in ipsilesional m1 in well-recovered patients with subcortical stroke. Stroke 45:788–793CrossRefPubMedGoogle Scholar
  32. 32.
    Carter AR, Astafiev SV, Lang CE et al (2010) Resting interhemispheric functional magnetic resonance imaging connectivity predicts performance after stroke. Ann Neurol 67:365–375Google Scholar
  33. 33.
    Park CH, Chang WH, Ohn SH et al (2011) Longitudinal changes of resting-state functional connectivity during motor recovery after stroke. Stroke 42:1357–1362Google Scholar
  34. 34.
    Hartwigsen G, Saur D (2017) Neuroimaging of stroke recovery from aphasia - insights into plasticity of the human language network. Neuroimage S1053–8119:31000–31005Google Scholar
  35. 35.
    Grefkes C, Fink GR (2014) Connectivity-based approaches in stroke and recovery of function. Lancet Neurol 13:206–216CrossRefPubMedGoogle Scholar
  36. 36.
    Grefkes C, Ward NS (2014) Cortical reorganization after stroke: how much and how functional. Neuroscientist 20:56–70CrossRefPubMedGoogle Scholar
  37. 37.
    Thiel A, Vahdat S (2015) Structural and resting-state brain connectivity of motor networks after stroke. Stroke 46:296–301CrossRefPubMedGoogle Scholar
  38. 38.
    Weder B, Knorr U, Herzog H et al (1994) Tactile exploration of shape after subcortical ischaemic infarction studied with PET. Brain 117(Pt 3):593–605Google Scholar
  39. 39.
    Carmichael ST (2006) Cellular and molecular mechanisms of neural repair after stroke: making waves. Ann Neurol 59:735–742CrossRefPubMedGoogle Scholar
  40. 40.
    Carmichael ST (2008) Themes and strategies for studying the biology of stroke recovery in the poststroke epoch. Stroke 39:1380–1388CrossRefPubMedPubMedCentralGoogle Scholar
  41. 41.
    Wu T, Hallett M (2013) The cerebellum in Parkinson’s disease. Brain 136:696–709CrossRefPubMedGoogle Scholar
  42. 42.
    Zhang D, Snyder AZ, Shimony JS, Fox MD, Raichle ME (2010) Noninvasive functional and structural connectivity mapping of the human thalamocortical system. Cereb Cortex 20:1187–1194CrossRefPubMedGoogle Scholar
  43. 43.
    Arcaro MJ, Pinsk MA, Kastner S (2015) The anatomical and functional organization of the human visual pulvinar. J Neurosci 35:9848–9871CrossRefPubMedPubMedCentralGoogle Scholar
  44. 44.
    Lam TK, Dawson DR, Honjo K et al (2018) Neural coupling between contralesional motor and frontoparietal networks correlates with motor ability in individuals with chronic stroke. J Neurol Sci 384:21–29CrossRefPubMedGoogle Scholar

Copyright information

© European Society of Radiology 2019

Authors and Affiliations

  • Li Chen
    • 1
    • 2
  • Tianyou Luo
    • 2
    Email author
  • Kangcheng Wang
    • 3
  • Yong Zhang
    • 4
  • Dandan Shi
    • 2
  • Fajin Lv
    • 2
  • Yang Li
    • 1
  • Yongmei Li
    • 2
  • Qi Li
    • 2
  • Weidong Fang
    • 2
  • Zhiwei Zhang
    • 2
  • Juan Peng
    • 2
  • Hanfeng Yang
    • 1
  1. 1.Department of RadiologyAffiliated Hospital of North Sichuan Medical CollegeNanchongChina
  2. 2.Department of RadiologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
  3. 3.Department of PsychologySouthwest UniversityChongqingChina
  4. 4.School of Foreign LanguagesSouthwest University of Political Science and LawChongqingChina

Personalised recommendations