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Title: Pathophysiology of unilateral asterixis due to thalamic lesion.
Authors: Inoue, Manabu
Kojima, Yasuhiro
Mima, Tatsuya
Sawamoto, Nobukatsu  kyouindb  KAKEN_id
Matsuhashi, Masao  kyouindb  KAKEN_id  orcid (unconfirmed)
Fumuro, Tomoyuki
Kinboshi, Masato
Koganemaru, Satoko
Kanda, Masutarou
Shibasaki, Hiroshi
Author's alias: 井上, 学
Keywords: Thalamic asterixis
Thalamic infarction
Asterixis-related cortical activity
Motor cortex excitability
Thalamo-cortical connectivity
Issue Date: Sep-2012
Publisher: Elsevier Ireland Ltd.
Journal title: Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology
Volume: 123
Issue: 9
Start page: 1858
End page: 1864
Abstract: [Objective]:Unilateral asterixis has been reported in patients with thalamic lesion. This study aims at elucidating the pathophysiology of the thalamic asterixis. [Methods]:Two cases with unilateral asterixis caused by an infarction in the lateral thalamus were studied by analysing the asterixis-related cortical activities, transcranial magnetic stimulation (TMS) for motor cortex excitability and probabilistic diffusion tractography for the thalamo-cortical connectivity. [Results]:Averaging of electroencephalogram (EEG) time-locked to the asterixis revealed rhythmic oscillations of a beta band at the central area contralateral to the affected hand. TMS revealed a decrease in the motor evoked potential (MEP) amplitude and a prolongation of the silent period (SP). The anatomical mapping of connections between the thalamus and cortical areas using a diffusion-weighted image (DWI) showed that the lateral thalamus involved by the infarction was connected to the premotor cortex, the primary motor cortex (M1) and the primary somatosensory cortex (S1) of the corresponding hemisphere. [Conclusions]:The thalamic asterixis is mediated by the sensorimotor cortex, which is subjected to excessive inhibition as a result of the thalamic lesion involving the ventral lateral nucleus. [Significance]:This is the first demonstration of participation of the sensorimotor cortex in the generation of asterixis due to the lateral thalamic lesion.
Rights: © 2012 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd.
この論文は出版社版でありません。引用の際には出版社版をご確認ご利用ください。This is not the published version. Please cite only the published version.
DOI(Published Version): 10.1016/j.clinph.2012.01.021
PubMed ID: 22425586
Appears in Collections:Journal Articles

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