Improving the Understanding of Neural Mechanisms and Guiding Targeted Therapy for Clinical Syndrome after Thalamic Infarction with Advanced Neuroimaging

Thalamic infarction can result in a diverse array of symptoms, including motor and sensory deficits, memory and attention difficulties, and alterations in mood and behavior; these symptoms are collectively referred to as thalamic infarction syndrome. The neural mechanisms underlying these symptoms are not yet fully understood, hampering the development of effective and individualized treatments. The current understanding of the pathology of thalamic infarction syndrome is mainly based on conventional computed tomography/magnetic resonance imaging scans, which reveal blood supply to various nuclei groups and clinical features. Thalamic infarction syndrome can be categorized into four groups according to the affected territory and associated vascular syndrome. Recent advancements in neuroimaging techniques, which enable the precise identification of affected pivotal thalamic subnuclei, altered brain structures, white matter pathway integrity, abnormal neural activity, and maladaptive states of brain networks, can enhance our understanding of the clinical mechanisms and inform the development of more effective therapeutic strategies. This review summarizes research on the pathological neural mechanisms of thalamic infarction syndrome and highlights future directions.