"Pusher syndrome" following cortical lesions that spare the thalamus

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"Pusher syndrome" following cortical lesions that spare the thalamus. / Johannsen, Leif; Broetz, D; Naegele, T; Karnath, H-O.

In: Journal of Neurology, Vol. 253, 01.04.2006, p. 455-463.

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Johannsen, Leif ; Broetz, D ; Naegele, T ; Karnath, H-O. / "Pusher syndrome" following cortical lesions that spare the thalamus. In: Journal of Neurology. 2006 ; Vol. 253. pp. 455-463.

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@article{1c946d47c77a45a58b869f432bbfa63d,
title = "{"}Pusher syndrome{"} following cortical lesions that spare the thalamus",
abstract = "Stroke patients with {"}pusher syndrome{"} show severe misperception of their own upright body orientation although visual-vestibular processing is almost intact. This dissociation argues for a second graviceptive system in humans for the perception of body orientation. Recent studies revealed that the posterior thalamus is an important part of this system. The present investigation aimed to study the cortical representation of this system beyond the thalamus. We evaluated 45 acute patients with and without contraversive pushing following left-or right-sided cortical lesions sparing the thalamus. In both hemispheres, the simple lesion overlap associated with contraversive pushing typically centered on the insular cortex and parts of the postcentral gyrus. The comparison between pusher patients and controls who were matched with respect to age, lesion size, and the frequency of spatial neglect, aphasia and visual field defects revealed only very small regions that were specific for the pusher patients with cortical damage sparing the thalamus. Obviously, the cortical structures representing our control of upright body orientation are in close anatomical proximity to those areas that induce aphasia in the left hemisphere and spatial neglect in the right hemisphere when lesioned. We conclude that in addition to the subcortical area previously identified in the posterior thalamus, parts of the insula and postcentral gyrus appear to contribute at cortical level to the processing of the afferent signals mediating the graviceptive information about upright body orientation.",
author = "Leif Johannsen and D Broetz and T Naegele and H-O Karnath",
year = "2006",
month = apr,
day = "1",
doi = "10.1007/s00415-005-0025-7",
language = "English",
volume = "253",
pages = "455--463",
journal = "Journal of Neurology",
issn = "0340-5354",
publisher = "Springer",

}

RIS

TY - JOUR

T1 - "Pusher syndrome" following cortical lesions that spare the thalamus

AU - Johannsen, Leif

AU - Broetz, D

AU - Naegele, T

AU - Karnath, H-O

PY - 2006/4/1

Y1 - 2006/4/1

N2 - Stroke patients with "pusher syndrome" show severe misperception of their own upright body orientation although visual-vestibular processing is almost intact. This dissociation argues for a second graviceptive system in humans for the perception of body orientation. Recent studies revealed that the posterior thalamus is an important part of this system. The present investigation aimed to study the cortical representation of this system beyond the thalamus. We evaluated 45 acute patients with and without contraversive pushing following left-or right-sided cortical lesions sparing the thalamus. In both hemispheres, the simple lesion overlap associated with contraversive pushing typically centered on the insular cortex and parts of the postcentral gyrus. The comparison between pusher patients and controls who were matched with respect to age, lesion size, and the frequency of spatial neglect, aphasia and visual field defects revealed only very small regions that were specific for the pusher patients with cortical damage sparing the thalamus. Obviously, the cortical structures representing our control of upright body orientation are in close anatomical proximity to those areas that induce aphasia in the left hemisphere and spatial neglect in the right hemisphere when lesioned. We conclude that in addition to the subcortical area previously identified in the posterior thalamus, parts of the insula and postcentral gyrus appear to contribute at cortical level to the processing of the afferent signals mediating the graviceptive information about upright body orientation.

AB - Stroke patients with "pusher syndrome" show severe misperception of their own upright body orientation although visual-vestibular processing is almost intact. This dissociation argues for a second graviceptive system in humans for the perception of body orientation. Recent studies revealed that the posterior thalamus is an important part of this system. The present investigation aimed to study the cortical representation of this system beyond the thalamus. We evaluated 45 acute patients with and without contraversive pushing following left-or right-sided cortical lesions sparing the thalamus. In both hemispheres, the simple lesion overlap associated with contraversive pushing typically centered on the insular cortex and parts of the postcentral gyrus. The comparison between pusher patients and controls who were matched with respect to age, lesion size, and the frequency of spatial neglect, aphasia and visual field defects revealed only very small regions that were specific for the pusher patients with cortical damage sparing the thalamus. Obviously, the cortical structures representing our control of upright body orientation are in close anatomical proximity to those areas that induce aphasia in the left hemisphere and spatial neglect in the right hemisphere when lesioned. We conclude that in addition to the subcortical area previously identified in the posterior thalamus, parts of the insula and postcentral gyrus appear to contribute at cortical level to the processing of the afferent signals mediating the graviceptive information about upright body orientation.

UR - http://www.scopus.com/inward/record.url?scp=33745673150&partnerID=8YFLogxK

U2 - 10.1007/s00415-005-0025-7

DO - 10.1007/s00415-005-0025-7

M3 - Article

C2 - 16435080

VL - 253

SP - 455

EP - 463

JO - Journal of Neurology

JF - Journal of Neurology

SN - 0340-5354

ER -