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Digital Handwriting Analysis of Characters in Chinese Patients with Mild Cognitive Impairment

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Thalamic alexia with agraphia.

Fábio Henrique de Gobbi Porto¹, Maria Isabel d'Ávila Freitas, Maira Okada de Oliveira

¹Behavioral and Cognitive Neurology Unit, Department of Neurology and Cognitive Disorders Reference Center (CEREDIC);

Neurology International

|May 18, 2012

Summary

Alexia with agraphia, a reading and writing deficit, can result from thalamic hemorrhage. This subcortical injury may cause widespread cognitive impairments due to thalamocortical disconnection.

Keywords:

agraphia with alexia diaschisis phenomenon thalamic lesion tract disconnection.

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Area of Science:

Neuroscience
Cognitive Neurology

Background:

Alexia with agraphia is an acquired reading and writing impairment, often linked to left angular gyrus lesions.
It can occur with aphasia or as an isolated deficit.

Observation:

A patient presented with alexia with agraphia and other cognitive deficits following a thalamic hemorrhage.
Neuropsychological evaluation revealed impairments in attention, executive function, arithmetic, and memory.
Language tests confirmed severe alexia with agraphia without aphasia.

Findings:

Imaging identified an old hemorrhage in the left thalamus (anterior, dorsomedial, pulvinar nuclei).
Tractography showed asymmetric thalamocortical radiations, and SPECT revealed left thalamic hypoperfusion extending to cortical areas.
These findings suggest subcortical injury can lead to cortical cognitive deficits.

Implications:

Thalamic lesions can cause cortical cognitive deficits like alexia with agraphia.
The mechanism likely involves diaschisis and thalamocortical tract disconnections.
This highlights the crucial role of thalamic nuclei in maintaining cognitive functions.