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Gerstmann Syndrome as a Disconnection Syndrome: A Single Case Diffusion Tensor Imaging Study.

Soo Hoon Yoon1, Jae Ik Lee1, Mun Jeong Kang1

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Gerstmann syndrome (GS) results from damage to the inferior parietal lobule (IPL). Neuroimaging reveals white matter pathway disruption, supporting GS as a disconnection syndrome.

Keywords:
Diffusion Tensor ImagingGerstmann SyndromeParietal LobeWhite Matter

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Area of Science:

  • Neuroscience
  • Neurology
  • Neuroimaging

Background:

  • Gerstmann syndrome (GS) is a rare neurological disorder characterized by agraphia, acalculia, finger agnosia, and right-left disorientation.
  • These symptoms arise from lesions in the dominant inferior parietal lobule (IPL).

Observation:

  • A 49-year-old male diagnosed with GS following a left parieto-occipital hemorrhage presented with anomic aphasia, agraphia, acalculia, finger agnosia, and impaired right-left discrimination.
  • Diffusion tensor tractography (DTT) demonstrated disrupted white matter tracts, including the superior longitudinal fasciculus (SLF) and posterior corpus callosum (CC), surrounding the left IPL.

Findings:

  • Fractional anisotropy (FA) values were significantly reduced in the left SLF and posterior CC compared to healthy controls.
  • These neuroimaging findings correlate with the patient's clinical presentation of Gerstmann syndrome.

Implications:

  • The study supports the hypothesis that Gerstmann syndrome is a disconnection syndrome resulting from white matter pathway lesions adjacent to the IPL.
  • Further research utilizing advanced imaging techniques is warranted to explore the relationship between white matter disconnections and GS development.