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Article abstract Using quantitative PET, the authors studied the binding of [¹¹C]PK11195, a marker of activated microglia, in the thalamus of patients with chronic middle cerebral artery infarcts. All patients showed increased [¹¹C]PK11195 binding in the ipsilateral thalamus, indicating the activation of microglia in degenerating projection areas remote from the primary lesion. A persistent increase in [¹¹C]PK11195 binding suggests active, long-term thalamic microstructural changes after corticothalamic connection damage.