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“Thalamic aphasia” after stroke is associated with left anterior lesion location

Abstract

Background

Aphasic symptoms are typically associated with lesions of the left fronto-temporal cortex. Interestingly, aphasic symptoms have also been described in patients with thalamic strokes in anterior, paramedian or posterolateral location. So far, systematic analyses are missing.

Methods

We conducted a retrospective analysis of consecutive patients admitted to our tertiary stroke care center between January 2016 and July 2017 with image-based (MRI) proven ischemic stroke. We evaluated stroke lesion location, using 3-T MRI, and presence of aphasic symptoms.

Results

Out of 1064 patients, 104 (9.8%) presented with a thalamic stroke, 52 of which (4.9%) had an isolated lesion in the thalamus (ILT). In patients with ILT, 6/52 had aphasic symptoms. Aphasic symptoms after ILT were only present in patients with left anterior lesion location (n = 6, 100% left anterior vs. 0% other thalamic location, p < 0.001).

Conclusions

Aphasic symptoms in thalamic stroke are strongly associated with left anterior lesion location. In thalamo-cortical language networks, specifically the nuclei in the left anterior thalamus could play an important role in integration of left cortical information with disconnection leading to aphasic symptoms.

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Author information

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by MF, CN and MI. The first draft of the manuscript was written by MF and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Correspondence to Merve Fritsch.

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Conflicts of interest

Dr. Villringer reports Grants from Center of Stroke Research Berlin funded by the German Ministry of Education and Research, during the conduct of the study. In addition, Dr. Villringer has a patent European Patent application 17179320.01-1906 pending. Dr. Fritsch, Manuela Ihrke, Dr. Klostermann, Dr. Krause and Dr. Nolte have nothing to disclose.

Ethical standards

In accordance with laws and regulations in the Federal State of Berlin, this retrospective study did not require an ethics committee approval (§25 Berliner Krankenhausgesetz).

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Cite this article

Fritsch, M., Krause, T., Klostermann, F. et al. “Thalamic aphasia” after stroke is associated with left anterior lesion location. J Neurol 267, 106–112 (2020) doi:10.1007/s00415-019-09560-1

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Keywords

  • Aphasia
  • Ischemic stroke
  • Lesion
  • Language network
  • Thalamus