RESUMO
We reported a case of an elderly female patient affected by musical hallucinations (MHs) as the unique symptom of a right temporal ischemic stroke. A functional magnetic resonance imaging examination was performed in the patient and in five age- and sex-matched normal controls (NC) to detect the complex neural substrate subserving MHs in such a context. Although an activation pattern involving the primary auditory cortex and the temporal associative areas bilaterally was found in the patient and NC, a significant increased activation mostly located in right temporal cortex (in the ischemic area), was observed in the patient. Further functional neuroimaging studies should be performed to detect the complex neural pathways underlying MHs and to find out differences between these hallucinations and real music perception.
Assuntos
Infarto Encefálico/complicações , Alucinações/complicações , Música/psicologia , Acidente Vascular Cerebral/psicologia , Lobo Temporal/patologia , Idoso de 80 Anos ou mais , Vias Auditivas/patologia , Vias Auditivas/fisiopatologia , Percepção Auditiva/fisiologia , Infarto Encefálico/patologia , Infarto Encefálico/fisiopatologia , Infarto Encefálico/psicologia , Estudos de Casos e Controles , Feminino , Lateralidade Funcional , Neuroimagem Funcional , Alucinações/patologia , Alucinações/psicologia , Humanos , Análise por Pareamento , Testes Neuropsicológicos , Valores de Referência , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/patologia , Lobo Temporal/fisiopatologiaAssuntos
Infarto Encefálico/complicações , Mapeamento Encefálico/métodos , Transtornos Cognitivos/etiologia , Demência Vascular/etiologia , Imageamento por Ressonância Magnética , Testes Neuropsicológicos , Encéfalo/patologia , Infarto Encefálico/patologia , Infarto Encefálico/psicologia , Transtornos Cognitivos/patologia , Transtornos Cognitivos/psicologia , Demência Vascular/complicações , Demência Vascular/patologia , Demência Vascular/psicologia , Humanos , Índice de Gravidade de DoençaRESUMO
BACKGROUND: The aim of the present study was to investigate whether there were differences in neuroradiological features, including white-matter lesions and gray-matter volumes, between patients with lacunar infarction with and without mild cognitive impairment of the vascular type (MCI-V). METHODS: A total of 40 patients with lacunar infarction were studied within 1 month after stroke. RESULTS: MCI-V was found in 22 patients, who in comparison with patients without cognitive impairment were significantly older and had fewer years of formal education. MRI subcortical hyperintensities especially in the basal ganglia (putamen and thalamus) were significantly more frequent in the MCI-V group. In the voxel-based morphometric study, patients with MCI-V showed more atrophy bilaterally in the middle temporal gyrus, right and left frontal and posterior bilateral occipitoparietal regions including the posterior cingulate as well as in the cerebellum. A region of interest analysis restricted to the parahippocampi and hippocampi showed further reduced bilateral parahippocampal gyrus and right hippocampus volume reductions in this group of patients. Finally, the amount of white-matter lesions among MCI-V showed negative correlations with gray-matter volume in frontal and temporal areas as well as with the thalamus and mesencephalon. CONCLUSIONS: The present findings provide support for an anatomical substrate of the MCI entity in patients with lacunar infarction. Both gray- and white-matter changes seem to contribute to the cognitive impairment of such patients.