TY  - CHAP
M1  - Book, Section
TI  - The Limbic System and Cerebral Circuits for Reward, Emotions, and Memory
A1  - Martin, John H.
PY  - 2021
T2  - Neuroanatomy: Text and Atlas, 5e
AB  - CLINICAL  CASE  |  Anterior  Temporal  Lobe  DegenerationA  67-year-old  woman  was  dining  with  her  family  when  she  was  not  able  to  recognize  a  food  she  commonly  ate.  She  had  been  an  empathetic  person  but  recently  has  begun  to  be  self-centered  and  unconcerned  about  others’  feelings,  including  those  of  her  daughter,  with  whom  she  was  close.  She  had  been  socially  dominant  and  extraverted,  but  recently  lost  that  dominance,  and  has  become  neurotic  and  introverted.  She  had  been  a  successful  travel  agent  and  had  visited  many  countries  worldwide,  but  she  was  now  unable  to  recall  the  names  of  many  of  the  places  she  had  visited  multiple  times.Over  the  next  2  years,  her  condition  progressed,  so  that  she  was  unable  to  recognize  familiar  people,  words,  and  objects.  Despite  having  normal  calculation  abilities,  she  stopped  controlling  her  own  finances.  Around  this  time,  her  eating  behavior  changed.  She  also  expressed  socially  inappropriate  behaviors.  For  example,  she  developed  a  preference  for  sweets  and  condiments,  and  sometimes  she  ate  condiments  as  food.  She  also  tried  to  eat  nonfood  items.  Her  basic  sensory  and  motor  functions  were  unaffected,  as  were  her  visuospatial  functions  and  episodic  memory.  Her  speech  and  language  were  grammatically  correct  and  fluent.Figure  16–1A  is  an  MRI  from  the  patient,  showing  clear  and  marked  degeneration  of  the  right  anterior  temporal  lobe;  Figure  16–1B  is  an  MRI  from  a  healthy  person  at  a  similar  placement  within  the  anterior  temporal  lobe.  Degeneration  is  manifested  both  as  a  reduction  in  the  gray  and  white  matter  of  the  anterior  temporal  lobe  and  insular  region,  as  well  as  a  corresponding  expansion  of  the  lateral  sulcus  and  other  temporal  lobe  sulci  (eg,  rostral  superior  temporal  sulcus).  Notice  that  other  brain  regions  (eg,  head  of  caudate  nucleus)  appear  normal.Answer  the  following  question  based  on  your  reading  of  this  chapter.1.  Where  in  the  temporal  lobe  is  there  degeneration  and  why  is  there  a  regional  reduction  in  gray  matter?2.  Why  is  the  space  of  the  lateral  sulcus  expanded?3.  What  are  the  general  classes  of  function  of  the  anterior  temporal  lobe?4.  Degeneration  also  encompasses  the  insular  cortex.  What  are  some  functions  of  the  insular  cortex?Key  neurological  signs  and  corresponding  damaged  brain  structuresFrontotemporal  dementiaConsidering  the  constellation  of  behavioral  signs,  the  progressive  nature  of  the  signs,  and  the  radiological  pattern  of  neural  degeneration,  the  patient  is  suffering  from  a  form  of  frontotemporal  dementia,  a  progressive  degenerative  disease  characterized  by  loss  of  parts  of  the  frontal  and/or  anterior  temporal  lobe;  it  can  be  lateralized.  In  this  patient,  it  is  primarily  right-sided.Brodmann’s  area  38,  amygdala,  and  corticocortical  connectionsBrodmann’s  area  38,  the  cortex  of  the  temporal  pole  (see  Figure  2–18),  has  corticocortical  interconnections  with  other  limbic  cortical  areas,  including  orbitofrontal  cortex;  it  is  interconnected  with  the  amygdala,  as  well.  These  areas  form  a  network,  so  that  the  personality  changes,  oral  tendencies,  and  semantic  impairments  are  difficult  to  attribute  to  a  single  structure.ReferencesGainotti  G,  Barbier  A,  Marra  C.  Slowly  progressive  defect  in  recognition  of  familiar  people  in  a  patient  with  right  anterior  temporal  atrophy.  Brain.  2003;126:792-803.Gorno-Tempini  ML,  Rankin  KP,  Woolley  JD,  Rosen  HJ,  Phengrasamy  L,  ...
SN  - 
PB  - McGraw Hill
CY  - New York, NY
Y2  - 2024/04/16
UR  - accessmedicine.mhmedical.com/content.aspx?aid=1189293778
ER  -