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分离半球对手势的模仿。

Imitation of gestures by disconnected hemispheres.

作者信息

Goldenberg G, Laimgruber K, Hermsdörfer J

机构信息

Neuropsychologische Abteilung, Krankenhaus München Bogenhausen, Englschalkingerstrasse 77, D 81925 Munich, Germany.

出版信息

Neuropsychologia. 2001;39(13):1432-43. doi: 10.1016/s0028-3932(01)00062-8.

Abstract

PU's corpus callosum was severed as a sequel of bleeding from an arteriovenous malformation. The lesion affects the truncus and the splenium and caused somatosensory and visual disconnection of the hemispheres. On clinical testing PU's left hand was apraxic for pantomime of object use but not for imitation. By contrast, when stimuli for imitation of meaningless hand and finger postures were presented tachistocopically to either the left or the right visual field, both hemispheres turned out to be apraxic in different ways. Imitation of hand postures was perfect for right-handed imitation of stimuli presented to the left hemisphere but defective in all other conditions. Imitation of finger postures was below the normal range in all conditions initially, but improved to normality for right-hand imitation of stimuli presented to the left hemisphere after repeated testing. After successful imitation of gestures presented to the left hemisphere PU commented that he imitated without really seeing the stimulus by "formulating the unseen", whereas after presentation to the right hemisphere he felt that he saw the stimulus but could not imitate. We propose that imitation of meaningless gestures affords a coding of gestures with reference to knowledge about body parts which can be applied only by the left hemisphere. Imitation of finger postures puts additional demands on fine grained visuospatial discrimination which necessitates a contribution by the right hemisphere.

摘要

作为动静脉畸形出血的后遗症,PU的胼胝体被切断。该病变影响胼胝体干和压部,导致半球的躯体感觉和视觉分离。在临床测试中,PU的左手在模拟使用物体时出现失用症,但在模仿时没有。相比之下,当以速示法向左侧或右侧视野呈现模仿无意义手部和手指姿势的刺激时,两个半球都以不同方式出现失用症。对于呈现给左半球的刺激,右手模仿手部姿势非常完美,但在所有其他情况下都有缺陷。最初,在所有情况下模仿手指姿势都低于正常范围,但在反复测试后,对于呈现给左半球的刺激,右手模仿时手指姿势模仿能力提高到正常水平。在成功模仿呈现给左半球的手势后,PU评论说,他通过“构想看不见的东西”在没有真正看到刺激的情况下进行模仿,而在呈现给右半球后,他觉得自己看到了刺激但无法模仿。我们提出,模仿无意义手势需要参照关于身体部位的知识对手势进行编码,而这只能由左半球完成。模仿手指姿势对精细的视觉空间辨别提出了额外要求,这需要右半球的参与。

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