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脑桥被盖脚内核病变导致的额叶综合征:简短的理论综述

Frontal syndrome as a consequence of lesions in the pedunculopontine tegmental nucleus: a short theoretical review.

作者信息

Winn P

机构信息

School of Psychology, University of St. Andrews, Fife, UK.

出版信息

Brain Res Bull. 1998 Dec;47(6):551-63. doi: 10.1016/s0361-9230(98)00136-1.

DOI:10.1016/s0361-9230(98)00136-1
PMID:10078613
Abstract

In this review, it is argued that the consequence of bilateral damage to the pedunculopontine tegmental nucleus (PPTg) in experimental animals is the production of a form of frontal syndrome. Frontal syndrome is a term used to describe the behavioural consequences of damage to the frontal lobes in human patients. These behavioural changes can be classified as disinhibition of behaviour (a release of behavioural control), the production of inappropriate behaviour (which in patients can be either inappropriate actions or verbal behaviour), and the production of perseverative behaviour (the maintenance of an action beyond the point at which it should have been terminated). The psychological changes which underlie these behavioural changes are thought to involve executive functions, which include such things as the prospective planning of sequences of actions, attentional shifting and working memory. In this review, I attempt to demonstrate two things: first, that there are significant anatomical connections from frontostriatal systems to the PPTg. The motor cortex projects directly to the PPTg while the prefrontal cortex contacts it via striatal circuitry, forming clear routes by which the frontal lobes can communicate with the PPTg. Second, having established the existence of connections between frontostriatal systems and the PPTg, behavioural data are described. Experimental animals bearing bilateral lesions of the PPTg have been examined in a wide variety of tasks. Animals bearing such lesions are not impaired in basic processes of feeding, drinking, locomotion, or grooming and simple observation of lesioned rats' normal behaviour reveals no obvious gross impairment in function. However, the results of more subtle tests reveal a wide variety of deficits in various tasks. The outcome of these experiments are in many ways contradictory, but in the vast majority of cases, the changes can be described as involving disinhibition of behaviour, the release of inappropriate behaviour, and the production of perseverative behaviour. Anatomical and behavioural data support the conclusion that there are functional connections between frontal systems and the PPTg. This review also discusses what psychological processes might be served by such connections.

摘要

在本综述中,有人认为实验动物双侧脚桥被盖核(PPTg)损伤的后果是产生一种额叶综合征。额叶综合征是一个用于描述人类患者额叶损伤行为后果的术语。这些行为变化可分为行为抑制解除(行为控制的释放)、不适当行为的产生(在患者中可以是不适当的动作或言语行为)以及持续性行为的产生(动作在本应终止的时间点之后仍持续)。这些行为变化背后的心理变化被认为涉及执行功能,其中包括诸如动作序列的前瞻性规划、注意力转移和工作记忆等方面。在本综述中,我试图证明两点:第一,从额叶 - 纹状体系统到PPTg存在重要的解剖学联系。运动皮层直接投射到PPTg,而前额叶皮层通过纹状体回路与之相连,形成了额叶与PPTg进行交流的清晰路径。第二,在确定了额叶 - 纹状体系统与PPTg之间存在联系之后,描述了行为数据。对患有双侧PPTg损伤的实验动物进行了各种各样的任务测试。患有此类损伤的动物在进食、饮水、运动或梳理毛发等基本过程中并未受损,对损伤大鼠正常行为的简单观察也未发现明显的功能严重受损。然而,更精细测试的结果显示在各种任务中存在广泛的缺陷。这些实验的结果在很多方面相互矛盾,但在绝大多数情况下,这些变化可以描述为涉及行为抑制解除、不适当行为的释放以及持续性行为的产生。解剖学和行为学数据支持额叶系统与PPTg之间存在功能联系这一结论。本综述还讨论了这种联系可能服务于哪些心理过程。

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