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      When the central integrator disintegrates: A review of the role of the thalamus in cognition and dementia

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          Abstract

          The thalamus is a complex neural structure with numerous anatomical subdivisions and intricate connectivity patterns. In recent decades, the traditional view of the thalamus as a relay station and “gateway to the cortex” has expanded in recognition of its role as a central integrator of inputs from sensory systems, cortex, basal ganglia, limbic systems, brain stem nuclei, and cerebellum. As such, the thalamus is critical for numerous aspects of human cognition, mood, and behavior, as well as serving sensory processing and motor functions. Thalamus pathology is an important contributor to cognitive and functional decline, and it might be argued that the thalamus has been somewhat overlooked as an important player in dementia. In this review, we provide a comprehensive overview of thalamus anatomy and function, with an emphasis on human cognition and behavior, and discuss emerging insights on the role of thalamus pathology in dementia.

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          Most cited references103

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          The diagnosis of dementia due to Alzheimer's disease: Recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease

          The National Institute on Aging and the Alzheimer's Association charged a workgroup with the task of revising the 1984 criteria for Alzheimer's disease (AD) dementia. The workgroup sought to ensure that the revised criteria would be flexible enough to be used by both general healthcare providers without access to neuropsychological testing, advanced imaging, and cerebrospinal fluid measures, and specialized investigators involved in research or in clinical trial studies who would have these tools available. We present criteria for all-cause dementia and for AD dementia. We retained the general framework of probable AD dementia from the 1984 criteria. On the basis of the past 27 years of experience, we made several changes in the clinical criteria for the diagnosis. We also retained the term possible AD dementia, but redefined it in a manner more focused than before. Biomarker evidence was also integrated into the diagnostic formulations for probable and possible AD dementia for use in research settings. The core clinical criteria for AD dementia will continue to be the cornerstone of the diagnosis in clinical practice, but biomarker evidence is expected to enhance the pathophysiological specificity of the diagnosis of AD dementia. Much work lies ahead for validating the biomarker diagnosis of AD dementia. Copyright © 2011. Published by Elsevier Inc.
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            Eighty-three brains obtained at autopsy from nondemented and demented individuals were examined for extracellular amyloid deposits and intraneuronal neurofibrillary changes. The distribution pattern and packing density of amyloid deposits turned out to be of limited significance for differentiation of neuropathological stages. Neurofibrillary changes occurred in the form of neuritic plaques, neurofibrillary tangles and neuropil threads. The distribution of neuritic plaques varied widely not only within architectonic units but also from one individual to another. Neurofibrillary tangles and neuropil threads, in contrast, exhibited a characteristic distribution pattern permitting the differentiation of six stages. The first two stages were characterized by an either mild or severe alteration of the transentorhinal layer Pre-alpha (transentorhinal stages I-II). The two forms of limbic stages (stages III-IV) were marked by a conspicuous affection of layer Pre-alpha in both transentorhinal region and proper entorhinal cortex. In addition, there was mild involvement of the first Ammon's horn sector. The hallmark of the two isocortical stages (stages V-VI) was the destruction of virtually all isocortical association areas. The investigation showed that recognition of the six stages required qualitative evaluation of only a few key preparations.
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              The attention system of the human brain.

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                Author and article information

                Contributors
                J.M.Biesbroek@umcutrecht.nl
                Journal
                Alzheimers Dement
                Alzheimers Dement
                10.1002/(ISSN)1552-5279
                ALZ
                Alzheimer's & Dementia
                John Wiley and Sons Inc. (Hoboken )
                1552-5260
                1552-5279
                02 December 2023
                March 2024
                : 20
                : 3 ( doiID: 10.1002/alz.v20.3 )
                : 2209-2222
                Affiliations
                [ 1 ] Department of Neurology UMC Utrecht Brain Center University Medical Center Utrecht Utrecht The Netherlands
                [ 2 ] Department of Neurology Diakonessenhuis Hospital Utrecht The Netherlands
                [ 3 ] VIB Center for Brain and Disease Leuven Belgium
                [ 4 ] Department of Neurosciences Katholieke Universiteit (KU) Leuven Leuven Belgium
                [ 5 ] Department of Experimental Psychology Helmholtz Institute Utrecht University Utrecht The Netherlands
                Author notes
                [*] [* ] Correspondence

                J. Matthijs Biesbroek, MD, PhD, Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, 85500, 3508 GA, The Netherlands.

                Email: J.M.Biesbroek@ 123456umcutrecht.nl

                Author information
                https://orcid.org/0000-0001-7017-2148
                https://orcid.org/0000-0002-6871-1330
                Article
                ALZ13563
                10.1002/alz.13563
                10984498
                38041861
                81433f16-bab2-4b5c-bc1d-779088a4c135
                © 2023 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 18 October 2023
                : 22 June 2023
                : 29 October 2023
                Page count
                Figures: 3, Tables: 1, Pages: 14, Words: 9916
                Funding
                Funded by: Veni
                Award ID: 9150162010055
                Funded by: ZonMw , doi 10.13039/501100001826;
                Award ID: 10510032120003
                Funded by: Vici
                Award ID: 918.16.616
                Categories
                Review Article
                Review Articles
                Custom metadata
                2.0
                March 2024
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.4.0 mode:remove_FC converted:01.04.2024

                cognition,dementia,functional anatomy,neuroanatomy,thalamus
                cognition, dementia, functional anatomy, neuroanatomy, thalamus

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