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Executive Dysfunction in Patients with Putaminal Hemorrhage.

Kae Kokubo1, Kyoko Suzuki2, Noriaki Hattori3

  • 1Department of Psychology, Kobegakuin University, Kobe, Japan; Neurorehabilitation Research Institute, Morinomiya Hospital, Osaka, Japan; Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|July 19, 2015
PubMed
Summary

Isolated putaminal hemorrhage causes frontal lobe dysfunction, impacting executive functions like sequencing and problem-solving. This study reveals subtle cognitive deficits without behavioral changes after putaminal stroke.

Keywords:
Putaminal hemorrhageWisconsin Card Sorting Testexecutive dysfunctionthe frontal–subcortical circuitsworking memory

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Area of Science:

  • Neuroscience
  • Neurology
  • Cognitive Science

Background:

  • Frontal-subcortical circuits connect the frontal cortex to the striatum, basal ganglia, and thalamus.
  • Disruptions in these circuits can lead to cognitive impairment with frontal lobe features.
  • The putamen is a key component of these circuits, yet frontal lobe functions after putaminal stroke are understudied.

Purpose of the Study:

  • To investigate whether putaminal hemorrhage leads to frontal lobe dysfunction.
  • To systematically examine frontal lobe functions in patients with focal putaminal lesions.

Main Methods:

  • Cognitive functions, particularly frontal lobe functions, were assessed in 15 patients with putaminal hemorrhage.
  • Assessments were conducted 2 months post-stroke onset.
  • Patient performance was compared against healthy controls.

Main Results:

  • Patients with putaminal hemorrhage showed significant deficits in frontal lobe tests, including Letter-Number Sequencing and lexical fluency.
  • Performance on the Wisconsin Card Sorting Test was significantly worse regarding categories achieved, perseverative errors, and set loss.
  • No aphasia, apraxia, spatial neglect, or behavioral impairments were observed.

Conclusions:

  • Isolated putaminal hemorrhage results in modest frontal lobe dysfunction without behavioral symptoms.
  • These findings suggest that putaminal hemorrhage disrupts dorsolateral-striato-pallido-thalamic circuits.
  • Executive dysfunction is a consequence of isolated putaminal hemorrhage.