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Apraxic agraphia following thalamic damage: Three new cases.

Dorien Vandenborre1, Kim van Dun2, Sebastiaan Engelborghs3

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Summary

Apraxic agraphia, a writing disorder, can result from thalamic strokes. This study highlights the thalamus

Keywords:
Apraxic agraphiaThalamic stroke

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Area of Science:

  • Neurology
  • Neuroscience
  • Cognitive Science

Background:

  • Apraxic agraphia (AA) is a peripheral writing disorder affecting skilled motor planning for writing.
  • Typically associated with parietal and frontal lesions, AA presents with illegible handwriting.
  • Sensorimotor, extrapyramidal, or cerebellar dysfunction is not the cause of AA.

Observation:

  • Three unique cases of AA following thalamic stroke are detailed.
  • Patients exhibited impaired handwriting but largely intact oral spelling.
  • Tc-99m ECD SPECT revealed decreased perfusion in prefrontal regions.

Findings:

  • The anterior and medial left thalamus is crucial for the graphomotor system.
  • Thalamic damage leading to AA may represent a diaschisis phenomenon.
  • This contrasts with the typical lesion locations associated with AA.

Implications:

  • Suggests the thalamus plays a critical role in the neural network for writing.
  • Highlights diaschisis as a potential mechanism for AA after focal thalamic lesions.
  • Expands understanding of the neuroanatomical basis of writing disorders.