Lausberg H, Göttert R, Münssinger U, Boegner F, Marx P
Neurologische Klinik und Poliklinik, Universitätsklinikum Benjamin Franklin, der Freien Universität, Berlin.
Neuropsychologia. 1999 Mar;37(3):253-65. doi: 10.1016/s0028-3932(98)00079-7.
We report on a left-handed patient with an ischemic infarction affecting exclusively the total length of the corpus callosum. This lesion clinically correlated with an almost complete callosal disconnection syndrome as described in callosotomy subjects, including unilateral verbal anosmia, hemialexia, unilateral ideomotor apraxia, unilateral agraphia, unilateral tactile anomia, unilateral constructional apraxia, lack of somesthetic transfer and dissociative phenomena. Despite the patient's left-handedness, his pattern of deficits was similar to the disconnection syndrome found in right-handers. Our report focusses on motor dominance and praxis. We followed-up the improvement in left apraxia and investigated the ability to initiate and learn a new visuo-motor skill. The results permit two tentative assumptions: (1) that the improvement in left apraxia was due to a compensatory increase in ipsilateral proximal muscle control, and (2) that motor dominance, i.e. the competence to initiate and learn a new movement pattern, was hemispherically dissociable from manual dominance in the sense of praxis control.
我们报告了一例仅累及胼胝体全长的缺血性梗死的左利手患者。该病变在临床上与胼胝体切开术患者中所描述的几乎完全的胼胝体离断综合征相关，包括单侧言语失嗅、偏侧失读症、单侧观念运动性失用症、单侧失写症、单侧触觉失命名症、单侧结构性失用症、本体感觉传递缺失和分离现象。尽管患者为左利手，但其缺陷模式与右利手患者中发现的离断综合征相似。我们的报告聚焦于运动优势和运用能力。我们随访了左侧失用症的改善情况，并研究了启动和学习一项新的视觉运动技能的能力。结果得出两个初步假设：（1）左侧失用症的改善是由于同侧近端肌肉控制的代偿性增加，以及（2）在运用能力控制方面，运动优势，即启动和学习一种新运动模式的能力，在半球上与手优势是可分离的。
