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Abulia
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===Damage to the capsular genu=== A case study involving two patients with [[acute confusional state]] and abulia was conducted to see if these symptoms were the result of an infarct in the capsular [[Genu of the corpus callosum|genu]]. Using clinical neuropsychological and MRI evaluations at baseline and one year later showed that the cognitive impairment was still there one year after the stroke. Cognitive and behavioral alterations due to a genu infarct are most likely because the thalamo-cortical projection fibers that originate from the ventral-anterior and [[Medial dorsal nucleus|medial-dorsal nuclei]] traverse the internal capsule genu. These tracts are part of a complex system of cortical and subcortical frontal circuits through which the flow of information from the entire cortex takes place before reaching the basal ganglia. Cognitive deterioration could have occurred through the genu infarcts affecting the inferior and anterior thalamic peduncles. In this case study the patients did not show any functional deficits at the follow-up one year after the stroke and were not depressed but did show diminished motivations. This result supports the idea that abulia may exist independently of depression as its own syndrome.<ref name="genu">Pantoni, L., Basile, A. M., Romanelli, M., Piccini, C., Sarti, C., Nencini, P., et al. (2001). Abulia and cognitive impairment in two patients with capsular genu infarct. [Article]. Acta Neurologica Scandinavica, 104(3), 185-190.</ref>
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