caa a22 4500 445810033 CHVBK 20180317145208.0 cr unu---uuuuu 170323e20110801xx s 000 0 eng 10.1007/s00415-011-5981-5 doi (NATIONALLICENCE)springer-10.1007/s00415-011-5981-5 Isolated thalamic agraphia with impaired grapheme formation and micrographia [Elektronische Daten] [Yasuhisa Sakurai, Yukinaga Yoshida, Koki Sato, Izumi Sugimoto, Toru Mannen] Two patients with isolated thalamic agraphia are described. Both showed kanji (Japanese morphograms) agraphia due to impaired character recall, grapheme deformity and micrographia (progressive reduction in character size during writing) after a lesion that involved the ventral lateral and ventroposterolateral nuclei. Single photon emission computed tomography with a 99mTc-ethylcysteinate dimer revealed hypoperfusion in the left precentral gyrus (Brodmann Area 6) and anterior supramarginal gyrus in both. Six months later, the extent of blood flow reduction decreased in the supramarginal gyrus in both patients and the precentral gyrus in patient 1. By this time, the writing impairment improved to nearly the normal range. Our study suggests that kanji agraphia (corresponding to lexical agraphia in Western countries) with poor grapheme formation and micrographia arises from a lesion in the ventral lateral and ventroposterolateral nuclei in the left thalamus. The accompaniment of poor grapheme formation and micrographia may reflect disruption of the cortico-subcortical motor circuit involving the putamen, thalamus, premotor cortex and sensorimotor cortex. It is also suggested that multiple cortical sites can be a target for secondary dysfunction that yields agraphia in a thalamic lesion, and that the recovery of reduced cortical blood flow does not always proceed in parallel with that of agraphia. Springer-Verlag, 2011 Apraxic agraphia nationallicence Pure agraphia nationallicence Alexia with agraphia nationallicence Kanji nationallicence Kana nationallicence Chinese characters nationallicence Sakurai Yasuhisa Department of Neurology, Mitsui Memorial Hospital, 1, Kanda-Izumi-cho, Chiyoda-ku, 101-8643, Tokyo, Japan aut Yoshida Yukinaga Department of Endoscopy, Tokyo Jikeikai Medical University Aoto Hospital, Tokyo, Japan aut Sato Koki Department of Neurology, Mitsui Memorial Hospital, 1, Kanda-Izumi-cho, Chiyoda-ku, 101-8643, Tokyo, Japan aut Sugimoto Izumi Department of Neurology, Mitsui Memorial Hospital, 1, Kanda-Izumi-cho, Chiyoda-ku, 101-8643, Tokyo, Japan aut Mannen Toru Department of Neurology, Mitsui Memorial Hospital, 1, Kanda-Izumi-cho, Chiyoda-ku, 101-8643, Tokyo, Japan aut Journal of Neurology Springer-Verlag 258/8(2011-08-01), 1528-1537 0340-5354 258:8<1528 2011 258 415 https://doi.org/10.1007/s00415-011-5981-5 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00415-011-5981-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Sakurai Yasuhisa Department of Neurology, Mitsui Memorial Hospital, 1, Kanda-Izumi-cho, Chiyoda-ku, 101-8643, Tokyo, Japan aut NATIONALLICENCE 700 1- Yoshida Yukinaga Department of Endoscopy, Tokyo Jikeikai Medical University Aoto Hospital, Tokyo, Japan aut NATIONALLICENCE 700 1- Sato Koki Department of Neurology, Mitsui Memorial Hospital, 1, Kanda-Izumi-cho, Chiyoda-ku, 101-8643, Tokyo, Japan aut NATIONALLICENCE 700 1- Sugimoto Izumi Department of Neurology, Mitsui Memorial Hospital, 1, Kanda-Izumi-cho, Chiyoda-ku, 101-8643, Tokyo, Japan aut NATIONALLICENCE 700 1- Mannen Toru Department of Neurology, Mitsui Memorial Hospital, 1, Kanda-Izumi-cho, Chiyoda-ku, 101-8643, Tokyo, Japan aut NATIONALLICENCE 773 0- Journal of Neurology Springer-Verlag 258/8(2011-08-01), 1528-1537 0340-5354 258:8<1528 2011 258 415 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer