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Apraxic agraphia due to thalamic infarction.

T Ohno1, M Bando, H Nagura

  • 1Department of Neurology, Tokyo Metropolitan Geriatric Hospital, Japan. ttakae-tky@umin.ac.jp

Neurology
|July 6, 2000
PubMed
Summary

A left thalamic infarction caused pure apraxic agraphia, a writing disorder, in a patient with normal motor skills. This suggests a remote effect on brain areas controlling writing.

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Area of Science:

  • Neuroscience
  • Neurology
  • Cognitive Science

Background:

  • Pure apraxic agraphia is a rare writing disorder characterized by the inability to write despite preserved language and motor functions.
  • The exact neuroanatomical basis of pure apraxic agraphia remains incompletely understood.

Observation:

  • A patient presented with pure apraxic agraphia following a stroke.
  • Neuroimaging revealed a lesion in the left thalamus, with reduced oxygen metabolism in the left dorsolateral premotor area.
  • No significant lesions were found in the frontal cortex, and word imaging was normal.

Findings:

  • Positron Emission Tomography (PET) with 15O-gas demonstrated hypometabolism in the left thalamus and left dorsolateral premotor cortex.
  • Magnetic Resonance Imaging (MRI) and 11C-flumazenil-PET did not reveal notable frontal cortical lesions.

Related Experiment Videos

  • The findings suggest a connection between thalamic damage and the disruption of writing abilities.

    • Implications:

    • Thalamic lesions may cause pure apraxic agraphia through remote effects on connected brain regions, specifically the premotor cortex.
    • This case highlights the critical role of the thalamus and its connections in the complex motor programming of writing.
    • Understanding these pathways is crucial for diagnosing and potentially treating agraphia.