Acute right opercular stroke-associated polyopic heautoscopy and hallucinations caused by disconnexion to the inferior parietal lobule through the superior longitudinal fasciculus III: a single case study

Dataset for the single case described in the paper CORTEX-D-23-00454R1 "Obrenovic M, Mouthon M, Chavan C, Saj A, Dieguez S, Aellen J, Chabwine JN. Acute right opercular stroke-associated polyopic heautoscopy and hallucinations caused by disconnexion to the inferior parietal lobule through the superior longitudinal fasciculus III: a single case study. Cortex"It contains two separate folder for this case: 1. behavour: Folder which contains the details clinical and investigation report (in French and English) as well as the Neuropsychological test answer of the patient.2. MRI: Folder which contains the MRI images. You will find brain anatomical scans (T1w, T1w with contrast agent, T2w, FLAIR and dwi images) as well as the diffusion imagery (Diffusion tensor tractography). Here you can find the abstract of the paper: Illusory neuropsychiatric symptoms such as hallucinations or the feeling of a presence (FOP) can occur in diffuse brain lesion or dysfunction, in psychiatric diseases as well as in healthy individuals. Their occurrence due to focal brain lesions is rare, most probably due to underreporting, which limits progress in understanding their underlying mechanisms and anatomical determinants. In this single case study, an 86-year-old patient experienced, in the context of an acute right central opercular ischemic stroke, visual hallucinatory symptoms (including palinopsia), differently lateralized auditory hallucinations and FOP. This unusual clinical constellation could be precisely documented and illustrated while still present, allowing a realistic and immersive visual experience validated by the patient. The acute stroke appeared to be their most plausible cause (after exclusion of other etiologies). Furthermore, accurate analysis of tractographic data suggested that disruption in the posterior bundle of the superior longitudinal fasciculus connecting the stroke lesion to the inferior parietal lobule was the anatomical substrate explaining all illusory symptoms, in coherence with existing literature. We could finally elaborate on symptoms taxonomy and phenomenology (e.g. polyopic heautoscopy, hallucinatory FOP, etc), and on patient’s remarkable distancing from them (with some therapeutic implications supported by plausibly engaged mechanisms). This case not only authentically enriched the description of such rare combination of heterogenous illusory symptoms through this novel visualization-based reporting approach, but disclosed an unrevealed anatomo-clinical link relating all of them to the acute stroke lesion through an association fiber, thereby contributing to the understanding of these intriguing symptoms and their determinants.本数据集对应论文CORTEX-D-23-00454R1中的单病例研究，原文作者为Obrenovic M、Mouthon M、Chavan C、Saj A、Dieguez S、Aellen J、Chabwine JN，论文标题为《通过上纵束III（superior longitudinal fasciculus III）连接下顶叶（inferior parietal lobule）的断开引发急性右侧岛盖卒中相关性复视自我感知幻觉与幻觉：一项单病例研究》（Acute right opercular stroke-associated polyopic heautoscopy and hallucinations caused by disconnexion to the inferior parietal lobule through the superior longitudinal fasciculus III: a single case study. Cortex）。本数据集包含两个独立文件夹： 1. 行为学（behaviour）文件夹：内含患者的临床细节与检查报告（含法语与英语版本）以及患者的神经心理学测试结果。 2. 磁共振成像（MRI）文件夹：内含脑部解剖扫描图像，包括T1加权（T1w）、增强T1加权（T1w with contrast agent）、T2加权（T2w）、液体衰减反转恢复（FLAIR）与弥散加权成像（dwi）图像，以及弥散张量纤维束追踪（Diffusion tensor tractography）图像。 以下为该论文的摘要： 虚构性神经精神症状（如幻觉或存在感（feeling of a presence, FOP））可出现于弥漫性脑损伤或功能异常、精神疾病群体及健康个体中。因局灶性脑损伤引发此类症状的情况较为罕见，推测可能与报告不足有关，这限制了学界对其潜在机制与解剖学决定因素的研究进展。 在本项单病例研究中，一名86岁患者在急性右侧中央岛盖缺血性卒中的病程中出现了视觉幻觉症状（包括视物显多症（palinopsia））、偏侧化听觉幻觉以及存在感幻觉。在症状仍存在时，研究团队对该罕见临床表型进行了精准记录与可视化呈现，并经患者本人验证了该逼真且沉浸式的视觉体验。排除其他病因后，急性卒中被认为是引发症状的最可能诱因。此外，对纤维束追踪数据的精准分析显示，连接卒中病灶与下顶叶的上纵束后部束支受损，是解释所有虚构性症状的解剖学基础，这与现有文献的结论相符。最终，研究团队对症状分类与现象学（如复视自我感知、幻觉性存在感等）进行了系统阐述，并探讨了患者对症状的显著疏离感及其潜在的治疗意义，该结论得到了相关机制的支持。 本病例不仅通过这种新颖的可视化报告方式，真实丰富了此类罕见异质性虚构症状组合的描述，还揭示了一条未被阐明的解剖-临床关联：通过联合纤维将所有症状与急性卒中病灶联系起来，从而为理解这些引人关注的症状及其决定因素提供了新的依据。