DISORDERS OF SMELL, TASTE, AND FOOD-INTAKE IN A PATIENT WITH A DORSOMEDIAL THALAMIC INFARCT

Background We report that a lasting deficit in the hedonic character o f olfactory and gustatory perception can be observed in bilateral dors omedial and intralaminar thalamic lesions. Case Description A 68-year- old patient abruptly presented with vigilance disorders associated wit h a reduction of olfactory and gustatory perceptions. A severe drop in appetite for foods and a weight loss of 10 kg were observed, which we re partially reversed with time. Two years later, the main persisting disorder was a change in the quality of perceptions: odors and taste w ere perceived either in a neutral way, their pleasant character having disappeared, or as unpleasant. However, identification was preserved. MRI showed that lesions principally involved the dorsomedial thalamic nuclei and the adjacent part of the intralaminar nuclei. Conclusions This case suggests that the dorsomedial thalamus may play a role in th e hedonic perception of food, thus affecting short-term regulation of food intake, and may possibly have a role in the long-term control of body weight.