Binkofski F, Buccino G, Dohle C, Seitz R J, Freund H J
Department of Neurology, Heinrich-Heine, University of Düsseldorf, Germany.
Ann Neurol. 1999 Jul;46(1):51-61. doi: 10.1002/1531-8249(199907)46:1<51::aid-ana9>3.0.co;2-q.
We describe two new clinical syndromes, mirror agnosia and mirror ataxia, both characterized by the deficit of reaching for an object through a mirror in association with a lesion of either parietal lobe. Clinical investigation of 13 patients demonstrated that the impairments affected both sides of the body. In mirror agnosia, the patients always reached toward the virtual object in the mirror and they were not capable of changing their behavior even after presentation of the position of the object in real visual space. In mirror ataxia (resembling optic ataxia) although some patients initially tended to reach for the virtual object in the mirror, they soon learned to guide their arms toward the real object, all of them producing many directional errors. Both patient groups performed poorly on mental rotation, but only the patients with mirror agnosia were impaired in line orientation. Only 1 of the patients suffered from neglect and 3 from apraxia. Magnetic resonance imaging showed that in mirror agnosia the common zone of lesion overlap was scattered around the posterior angular gyrus/superior temporal gyrus and in mirror ataxia around the postcentral sulcus. We propose that both these clinical syndromes may represent different types of dissociation of retinotopic space and body scheme, or likewise, of allocentric and egocentric space normally adjusted in the parietal lobe.
我们描述了两种新的临床综合征，即镜像失认症和镜像共济失调，二者均表现为因顶叶病变而无法通过镜子伸手抓取物体。对13名患者的临床研究表明，这些损伤影响身体两侧。在镜像失认症中，患者总是朝着镜子中的虚拟物体伸手，即使在实际视觉空间中呈现物体位置后，他们也无法改变行为。在镜像共济失调（类似于视觉性共济失调）中，尽管一些患者最初倾向于朝着镜子中的虚拟物体伸手，但他们很快学会将手臂伸向真实物体，不过所有人都会产生许多方向错误。两组患者在心理旋转任务中表现都很差，但只有镜像失认症患者在线条定向方面受损。仅1名患者存在偏侧忽视，3名患者存在失用症。磁共振成像显示，在镜像失认症中，病变重叠的共同区域分散在后角回/颞上回周围，而在镜像共济失调中则围绕中央后沟。我们提出，这两种临床综合征可能代表了视网膜空间和身体图式的不同类型分离，或者同样地，代表了在顶叶中通常相互协调的异心空间和自我中心空间的分离。
