| A disconnection account of Gerstmann syndrome: functional neuroanatomy evidence. | |
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MedLine Citation:
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PMID: 19938150 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To examine the functional neuroanatomy that could account for pure Gerstmann syndrome, which is the selective association of acalculia, finger agnosia, left-right disorientation, and agraphia. METHODS: We used structural and functional neuroimaging at high spatial resolution in healthy subjects to seek a shared cortical substrate of the Grundstörung posited by Gerstmann, ie, a common functional denominator accounting for this clinical tetrad. We construed a functional activation paradigm that mirrors each of the four clinical deficits in Gerstmann syndrome and determined cortical activation patterns. We then applied fiber tracking to diffusion tensor images and used cortical activation foci in the four functional domains as seed regions. RESULTS: None of the subjects showed parietal overlap of cortical activation patterns from the four cognitive domains. In every subject, however, the parietal activation patterns across all four domains consistently connected to a small region of subcortical parietal white matter at a location that is congruent with the lesion in a well-documented case of pure Gerstmann syndrome. INTERPRETATION: Our functional neuroimaging findings are not in agreement with Gerstmann's postulate of damage to a common cognitive function underpinning clinical semiology. Our evidence from intact functional neuroanatomy suggests that pure forms of Gerstmann's tetrad do not arise from lesion to a shared cortical substrate but from intraparietal disconnection after damage to a focal region of subcortical white matter. |
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Authors:
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Elena Rusconi; Philippe Pinel; Evelyn Eger; Denis LeBihan; Bertrand Thirion; Stanislas Dehaene; Andreas Kleinschmidt |
Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Annals of neurology Volume: 66 ISSN: 1531-8249 ISO Abbreviation: Ann. Neurol. Publication Date: 2009 Nov |
Date Detail:
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Created Date: 2009-11-30 Completed Date: 2009-12-21 Revised Date: 2009-12-24 |
Medline Journal Info:
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Nlm Unique ID: 7707449 Medline TA: Ann Neurol Country: United States |
Other Details:
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Languages: eng Pagination: 654-62 Citation Subset: IM |
Affiliation:
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Institut Nationale de la Santé et de la Recherche Médicale (INSERM), Unité 562, Gif-sur-Yvette, France. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Brain Mapping
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methods Cerebral Cortex / anatomy & histology*, physiology*, physiopathology Functional Laterality / physiology* Gerstmann Syndrome / pathology*, physiopathology Humans Magnetic Resonance Imaging / methods Male Psychomotor Performance / physiology Young Adult |
| Comments/Corrections | |
Erratum In:
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Ann Neurol. 2009 Dec;66(6):869 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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