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Korea Proprioceptive Neuromuscular Facilitation Association (대한고유수용성신경근촉진법학회)
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Confabulation Following Injury of the Papez Circuit as a Result of Middle Cerebral Artery Infarction: A Diffusion Tensor Tractography Study

중대뇌동맥 허혈에 의한 파페츠 회로 손상과 작화증

  • Yeo, Sang-Seok (Department of Physical Therapy, College of Health Sciences, Dankook University)
  • 여상석 (단국대학교 보건과학대학 물리치료학과)
  • Received : 2016.04.20
  • Accepted : 2016.04.28
  • Published : 2016.04.30
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Abstract

Purpose: In general, confabulation is defined as confusion of reality with past events without apparent prompting, in association with disruption of the capacity for retrieval and encoding of memory. We report on a patient who showed spontaneous confabulation associated with injury of the Papez circuit following middle cerebral artery (MCA) infarction. Methods: A 67-year-old female patient suffered cerebral infarct resulting from spontaneous MCA territory. After onset of the MCA infarct, she showed severe memory impairment and provoked confabulation. The Papez circuit was reconstructed for evaluation of part of it using diffusion tensor tractography (DTT). Fractional anisotropy (FA), mean diffusivity (MD), and tract volume were measured. Results: The right thalamocingulate tract showed a significant decrement of FA value and tract volume, and an increment of MD value by more than two standard deviations of that of normal control subjects. The tract volume in the left fornix and mammillothalamic tract decreased by more than two standard deviations of that of normal control subjects. Conclusion: Injuries of the Papez circuit were demonstrated in a patient who showed severe memory impairment and provoked confabulation following MCA infarct. We believe that analysis of the Papez circuit tract using DTT is useful in elucidating the cause of provoked confabulation in patients with MCA infarct.

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References

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