Bénaïm C, Blatt J L, Rousseaux M
Service de Rééducation Neurologique, Hôpital Swynghedauw, Lille.
Rev Neurol (Paris). 2000 Jul;156(6-7):622-33.
The aim of this study was to analyze the ipsilateral upper limb and head kinematics in patients presenting with spatial neglect, using pointing and grasping to object. Four patients were included and compared to an equivalent number of normal subjects. Head, shoulder, and wrist movements were recorded using a three-dimensional VICON system. Objects to be pointed or grasped were localized in the right or left space facing the subject. Patients presented with a reduction in the mean wrist velocity, which was more obvious when directed to the left side, reduction in the peak velocity, and a severe increase of the time between the peak velocity and the end of the movement. The amplitude and mean velocity of left head movements were comparable in both groups. The analysis of the intersegmental co-ordination showed that the sequence of activation of corporeal segments was similar in patients and controls: head movement, shoulders rotation, upper limb extension. Co-ordination between head and wrist movements was assessed using the cross-correlation method. An increase in time lag and a reduction in crossed correlations between the head and wrist movements was observed in leftward movements of neglect patients, but the co-ordination between the shoulder and wrist movements was preserved. Thus, we demonstrated a global disorder of intentional movements in patients, which was relatively similar in pointing and grasping to object, and predominated on the approach phase, which is associated to important visuo-motor adjustments. This study also demonstrated desynchronization of head and wrist movements, which can be an important problem in neglect patients.
本研究旨在分析存在空间忽视的患者在指向和抓握物体时同侧上肢和头部的运动学情况。纳入了4例患者，并与同等数量的正常受试者进行比较。使用三维VICON系统记录头部、肩部和腕部的运动。待指向或抓握的物体位于受试者前方的右侧或左侧空间。患者的平均腕部速度降低，向左时更明显，峰值速度降低，且峰值速度与运动结束之间的时间严重增加。两组的左侧头部运动幅度和平均速度相当。节段间协调性分析表明，患者和对照组身体节段的激活顺序相似：头部运动、肩部旋转、上肢伸展。使用互相关方法评估头部和腕部运动之间的协调性。在忽视患者的向左运动中，观察到头部和腕部运动之间的时间滞后增加且交叉相关性降低，但肩部和腕部运动之间的协调性得以保留。因此，我们证明了患者存在整体的意向性运动障碍，在指向和抓握物体时相对相似，且在与重要视觉运动调整相关的接近阶段占主导。本研究还证明了头部和腕部运动的不同步，这可能是忽视患者的一个重要问题。
