Left Dorsomedial Thalamic Damage Impairs Verbal Recall More Than Recognition: A Case Report

Damage to the dorsomedial thalamus usually leads to impaired episodic memory, attention, and executive function, but the role of the dorsomedial thalamus in memory processing is still not fully understood. Clinical evidence is inconclusive about whether dorsomedial thalamic damage impairs recall or whether it impairs recognition. I report a unique patient who suffered a cardioembolic stroke in the paramedian artery territory, caused by a patent foramen ovale. He was left with a chronic ischemic lesion centered in the parvocellular and, to a lesser extent, the magnocellular portions of the left dorsomedial thalamic nucleus, and marginally involving the midline and intralaminar nuclei. A year after the stroke, the patient's neuropsychological assessment showed a selective verbal memory deficit with greater loss of recall than recognition. His memory was normal when he was given semantically encoded material. His test results showed that damage to the left dorsomedial thalamic nucleus might affect both his recall and recognition because of the involvement of the parvocellular and magnocellular portions, respectively. The results also suggest that the left dorsomedial thalamus is involved in the encoding of verbal material. This case report highlights the role that the left dorsomedial thalamus plays in processing memory specific to verbal material. The findings point to the differential contribution of the dorsomedial parvocellular nucleus to recall, and support the theory that prefrontal strategic memory is enabled by adequate encoding of information through thalamocortical connectivity with the dorsolateral prefrontal cortex.