{"doi":"10.1016/j.pmrj.2015.07.017","title":"Thalamic Dysmetria","abstract":null,"journal":"PM&R","year":2016,"id":614336,"datarank":0.24141568686511508,"base_score":1.6094379124341003,"endowment":1.6094379124341003,"self_citation_contribution":0.24141568686511508,"citation_network_contribution":0.0,"self_endowment_contribution":0.24141568686511508,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":4,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":356997,"name":"Anoop Shah","orcid":"0000-0002-2825-3419","position":1,"is_corresponding":false},{"id":1583026,"name":"Chad Metzger","orcid":null,"position":2,"is_corresponding":false},{"id":1583027,"name":"Eric L. Altschuler","orcid":null,"position":3,"is_corresponding":false},{"id":1583025,"name":"Ryan Menard","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Thalamic Dysmetria","abstract":"Dysmetria (“wrong length”) is a clinical sign that manifests in the upper extremity as the inability to alternatively touch another person's fingertip with one's own fingertip and then touch the tip of one's own nose. Although dysmetria can indicate cerebellar damage and is usually taken as a sign of such damage, lesions affecting other structures also can cause dysmetria. Recently we have treated a number of patients with unilateral thalamic lesions resulting from stroke who have no cerebellar damage but have exhibited the sign of dysmetria. For example, a 63-year-old patient with a history of hypertension presented with right-sided weakness and speech difficulties. Upon examination the patient had an ataxic gait, 4+/5 weakness on the right side (normal 5/5 strength on the left side), right arm dysmetria (Video 1), and mild right facial droop with normal sensation bilaterally. Findings of the remainder of the neurologic and general physical examination were normal. Magnetic resonance imaging (Figure 1) showed a left thalamic hemorrhage and no cerebellar lesions. With physical and occupational therapy the patient improved over 10 days from a moderate assistance level for ambulation (with a rolling walker) and activities of daily living to a supervision level for these activities. The right arm dysmetria and gait ataxia improved concomitantly. A T1-weighted magnetic resonance imaging scan shows a left thalamic hemorrhage (arrowhead) with intraventricular extension without hydrocephalus. Patients with cerebellar dysmetria typically both start on an incorrect initial trajectory and cannot make the necessary correction 1. In contrast, our patient reaches more slowly with the affected right hand (Video 1) than with the unaffected left hand (Video 2), and while starting off on a grossly correct trajectory, fluid online guidance of the reaching finger seems to be lacking, requiring multiple subtle discrete corrections to arrive correctly at the target. Dysmetria has been noted to be part of a thalamic ataxia syndrome 2, although we are not aware of the availability of video of the thalamic dysmetria sign. This case illustrates the subtle but crucial—and still incompletely understood—role that the thalamus plays in motor control. Clinically it is important to appreciate that (1) dysmetria does not equate with cerebellar damage, (2) physical examination may be useful in parsing the lesion site, and (3) patients with dysmetria may have different rehabilitation issues, trajectories, and outcomes depending on the lesion site. Supplementary materials Video 1 Supplementary materials Video 2 Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.","is_dataset_classified":null,"base_score":1.6094379124341003,"endowment":1.6094379124341003,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"26278997","pmcid":null,"openalex_id":"https://openalex.org/W4244416825","authors":[],"funders":[],"total_grants":0,"fwci":0.2583,"citation_percentile":0.52519602,"influential_citations":0,"citation_trend":[{"year":2017,"count":1},{"year":2018,"count":1},{"year":2019,"count":1},{"year":2023,"count":1}],"oa_status":"closed","license":"http://onlinelibrary.wiley.com/termsAndConditions#vor","oa_locations":[{"url":"https://api.elsevier.com/content/article/PII:S1934148215009284?httpAccept=text/xml","host_type":"publisher"},{"url":"https://api.elsevier.com/content/article/PII:S1934148215009284?httpAccept=text/plain","host_type":"publisher"},{"url":"https://onlinelibrary.wiley.com/doi/pdf/10.1016/j.pmrj.2015.07.017","host_type":"publisher"},{"url":"https://onlinelibrary.wiley.com/doi/full-xml/10.1016/j.pmrj.2015.07.017","host_type":"publisher"},{"url":"https://doi.org/10.1016/j.pmrj.2015.07.017","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/26278997","host_type":"repository"}],"fields_of_study":["Genetic Neurodegenerative Diseases","Ophthalmology and Eye Disorders","Neurology and Historical Studies","Cerebellar Ataxia","Female","Humans","Magnetic Resonance Imaging","Middle Aged","Motor Activity","Thalamus"],"mesh_terms":["Cerebellar Ataxia","Female","Humans","Magnetic Resonance Imaging","Middle Aged","Motor Activity","Thalamus"],"keywords":["Dysmetria","Intention tremor","Medicine","Ataxic Gait","Weakness","Ataxia","Facial weakness","Neurological examination","Physical examination","Magnetic resonance imaging","Physical medicine and rehabilitation","Surgery","Radiology"],"sdg_mappings":[],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-02T12:35:07.519469Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}