Chapter 141

Thalamus
PY10.7: Describe and discuss functions of cerebral
cortex, basal ganglia, thalamus,
hypothalamus, cerebellum and limbic
system and their abnormalities
 LEARNING OBJECTIVES
On completion of study of this chapter: The student will be able to: (MUST KNOW)
1. Name the major nuclear groups in the thalamus and give their functions.
2. Appreciate the functional organization of thalamus.
3. List the functions of thalamus.
4. Describe the thalamic functions.
5. Correlate the functions of thalamus with thalamic dysfunctions.
6. Mention the functions of epithalamus and subthalamus.
The student may also be able to: (DESIRABLE TO KNOW)
1. Describe the connections and functions of thalamus.
FUNCTIONAL ORGANIZATION
Thalamus is an egg-shaped nuclear structure sitting obliquely atop the brain stem. It is known as the sensory
relay station. It receives ascending sensory inputs and projects them to the sensory cortical areas. Afferent
fibers of the ascending reticular formation also project to the thalamus and the thalamus receives input
from the cortex, mainly from the layer VI. There are two thalami on both sides. Anteriorly, they are
separated by the third ventricle and the corpora quadrigemina is present between their posterior parts.
Thalamic Nuclei
The thalamus is composed of a number of discrete nuclei. The thalamocortical and corticothalamic fibers
form the external medullary lamina that covers the lateral surface of the thalamus and passes between the
reticular nucleus and the rest of the thalamus.
1. Anatomically, a Y-shaped internal medullary lamina splits the thalamus into three parts. These are
anterior, medial, and lateral group of nuclei (Fig. 141.1).
2. The anterior group of nuclei is enclosed by the bifurcation of the internal medullary lamina.
3. The medial group of nuclei consists of the medial nucleus, the midline nucleus, centromedian, and the
intralaminar nucleus (Fig. 141.2).
4. The lateral group of nuclei is further divided into dorsal and ventral nuclear groups of nuclei.
5. The dorsal nuclear group contains lateral posterior nucleus, lateral dorsal nucleus, and pulvinar.
6. The ventral nuclear group is comprised of ventral anterior, ventral lateral, and ventral posterior nuclei,
and medial and lateral geniculate bodies (Figs. 141.3A and B)
7. The ventral posterior group, also known as ventrobasal complex, consists of venteroposterolateral and
ventroposteromedian groups of nuclei (Flowchart 141.1).
PHYSIOLOGICAL CLASSIFICATION: However, physiologically, there are four groups of nuclei:
1. Specific relay nuclei: Ascending afferent inputs synapse on these nuclei. The axons arising from them transmit the
afferent impulse to the cortex. This nuclear group consists of ventrobasal complex (VBC), lateral geniculate body
(LGB), medial geniculate body (MGB), and anterior nucleus (Fig. 141.4). • VBC receives inputs from dorsal column
pathway, anterolateral system, and corticothalamic fibers, and projects to the somatosensory cortex. • The
trigeminal lemniscus carries the general sensations from face along with the gustatory afferents and project to the
ventral posterior (VP) nucleus that transmits the afferent inputs to the postcentral gyrus (Fig. 141.5). • LGB receives
input from the optic tract and projects to the visual cortex (Fig. 141.6). • MGB receives input from the auditory
pathway and projects to the auditory cortex (Fig. 141.7). • The anterior nucleus receives inputs from the
hypothalamus through the mammillothalamic tract and relays the information to the cingulate gyrus.
2. Association nuclei: This nuclear group consists of pulvinar, dorsal nuclei, and lateral posterior nucleus (Fig. 141.8).
• These nuclei receive inputs from the sensory cortex and limbic system and project diffusely to the association
cortex or to sub-cortical structures • The pulvinar projects to the inferior parietal lobe. • The dorsolateral nucleus is
reciprocally connected to the precuneate gyrus.
3. Nonspecific nuclei: These include intralaminar (IM) (Fig. 141.9), midline (Fig. 141.10), centromedian (CM) nuclei, and
reticular nuclei (RET). • They receive inputs mainly from reticular formation and paleospinothalamic tract, and also
inputs from the striatum, hypothalamus, and other thalamic nuclei. • They project diffusely to the wide areas of the
cerebral cortex, to the thalamus and limbic system.
4. Motor nuclei: These include lateral, ventral anterior, and ventral lateral nuclei (Fig. 141.11).
 THALAMIC ORGANIZATION AND FUNCTIONS
The ascending somatosensory pathways terminate in certain thalamic nuclei. The sensory signals mostly arise from contralateral
receptors of the body. 1. Axons from cells in the dorsal column nuclei cross the brain stem immediately at the level of the
medulla and travel in the contralateral medial lemniscus to terminate primarily in the ventral-posterolateral nucleus (VPL) of the
thalamus. 2. The fibers of the anterolateral system (lateral and anterior spinothalamic tracts) travel in the contralateral
anterolateral funiculus of the spinal cord to terminate in the VPL, posterior (PO), and intralaminar (IM) nuclei. 3.
Reticulothalamic fibers of the spinoreticulothalamic pathway remain largely uncrossed and terminate in IM, midline, or
centromedian (CM) nuclei, and in the thalamic reticular nuclei (RET). The VPL and PO project to cortical regions. IM diffusely
projects to the cortex and RET is reciprocally connected with other thalamic nuclei. Ventral-posterolateral (VPL) Nucleus The VPL
receives input from many of ascending sensory pathways. Each pathway has a typical pattern of termination in the VPL nucleus.
The central core of the VPL nucleus receives largely cutaneous inputs. The dorsal aspect of VPL receives mostly deep inputs,
whereas the anterior surface receives muscle inputs. Thus, the VPL consists of a core of cutaneous inputs and a shell of deep
inputs. The afferent fibers from the face, arm, and leg are represented in a medial to lateral manner in the VPL nucleus. Posterior
Nuclei (PO) PO receives nociceptive inputs. Cells in PO respond to a variety of somatic and non-somatic modalities. PO is mainly
involved in the transmission of nociceptive impulses. Large lesion in PO produces analgesia and stimulation of PO produces pain
sensations. However, there is no somatotopic organization in PO. Intralaminar Nuclei and Reticular Nuclei Cells in intralaminar
nuclei (IM) have large, somatic receptive fields. They are activated by nociceptive and other sensory stimuli. Responses in IM are
strongly affected by the level of arousal, attention, and affect. Cells in reticular nuclei (RET) respond to a variety of
somatosensory modalities. IM has diffuse but strong projection to the cortex, striatum and limbic system. RET does not project
to the cortex but is reciprocally connected to other thalamic nuclei. Thus, RET is involved in the modulation of thalamic activity.
 FUNCTIONS OF THALAMUS
All afferent impulses on their way to the sensory cortex terminate in the thalamus.
1. Relay station for all somatic sensations: Thalamus conveys the sensory information to the cortex through
thalamocortical projections (Table 141.1). • Thus, it is the major relay station for sensory inputs in humans and
higher order of animals, whereas in lower order of animals, it acts as the center for sensory integration.
2. Relay of special sensations: Thalamus is the relay center for all special sensations except olfaction. • The
lateral and medial geniculate bodies receive the visual and auditory afferents, respectively. • The VPL nucleus
receives the taste afferents.
3. Arousal mechanisms: Thalamocortical projects from the nonspecific nuclei to the cortex contribute to the
reticular activating system that activates arousal mechanisms and keeps the individual awake.
4. Subcortical perception of sensations: Subcortical perception of pain, temperature, and pressure (crude touch)
occurs to some extent in the thalamus. • Thalamus is not only the relay station, but also the integration center
for these sensations. Therefore, these sensations remain intact considerably in cortical lesion.
5. Motor Functions: Thalamus is an integral part of motor loop of the brain in which globs pallidus of basal
ganglia projects mainly to the VPL nucleus of the thalamus (via pallidothalamic tract) and thalamus projects to
the motor cortex (via thalamocortical fibers), which projects back to the basal ganglia. • Through motor loop,
the thalamus influences postural movemen
 • The thalamus also links cerebellum and motor cortex via dentato-rubro-thalamo-cortical tract. • Through this
connection, the thalamus influences planning and programming of movements.
6. Memory and emotion: Anterior thalamus is a constituent of Papez circuit. • It receives input from the
mammillary body of the limbic system via the mammillothalamic tract. • Through this connection, the
thalamus is concerned with recent memory and emotion.
7. Synchronization of EEG: Stimulation of intralaminar thalamic nuclei at low frequency causes synchronization of
EEG waves recorded from the ipsilateral cortex. • This is called recruiting response. • However, high frequency
stimulation causes arousal and desynchronization.
8. Role in sleep: A circuit linking the thalamus and cortex (thalamocortical loop) is important in generating the
pattern of brain activity in sleep–wake cycle. • Inhibitory thalamic reticular neurons are proposed to be the
part of this neuronal network that causes induction of sleep.
9. Sensory motor coordination: The thalamus receives all sensory inputs from the body and closely interacts with
basal ganglia, cerebellum, and motor cortex. • Therefore, thalamus is one of the major structures in the brain
for coordination between sensory and motor functions, especially in the sensory feedback for correction and
improvement in motor output.
10. Language and speech: Dorsal lateral nucleus of thalamus is reciprocally connected with the parietal lobe of the
brain, and therefore is concerned with language and speech and complex integrated functions.
APPLIED ASPECTS
Thalamic Syndrome Lesion of the VPL occurs due to thrombosis of the posterolateral branch of the posterior
cerebral artery. 1. This results in severe impairment of the discriminative touch and pressure sensations of
contralateral side, whereas diffuse touch, temperature, and pain sensations are often less impaired. 2. Also,
there will be decreased muscle tone, profound weakness of the muscles, and ataxia as the VPL nucleus
receives afferent impulses from the cerebellum and relays them to the motor cortex, area 4 and 6. 3. The
emotion may be affected. 4. Vascular lesions usually spare the medial thalamus including VPM nuclear
group. Therefore, sensations in the face and head often remain intact.
Other Deficits
When the thalamus is damaged, not only thalamic functions are lost, but also many cortical functions are
affected, as the cortex is intimately connected with the thalamus. Electrical lesion of intralaminar nuclei
relieves chronic suffering type of pain, though the acute perception of pain remains intact.
EPITHALAMUS The epithalamus consists of the structures that form the roof of the third ventricle. These include the
pineal gland, the habenular nuclei, and the stria medullaris. Externally, it is seen above the superior colliculi
SUBTHALAMUS
The subthalamus is located between the upper end of substantia nigra and the thalamus. Subthalamus contains sensory
fasciculi, rostral extensions of the midbrain nuclei, fiber bundle from the cerebellum and globus pallidus, and
subthalamic nuclei. Fibers in the supramammillary commissure interconnect subthalamic structures. The subthalamic
nucleus (body of Luys) has reciprocal connection with the globus pallidus. Lesion of subthalamic nucleus results in
hemiballismus (for details, see Basal Ganglia)