Nass R, Sadler A E, Sidtis J J
Department of Neurology, New York Hospital-Cornell University Medical Center, New York.
Neurology. 1992 Oct;42(10):1960-5. doi: 10.1212/wnl.42.10.1960.
We assessed dichotic speech and complex-pitch discrimination in nine young patients with unilateral left-hemisphere injury and eight young patients with unilateral right-hemisphere injury incurred in the pre-perinatal (congenital) period. As in adults with acquired unilateral lesions, both congenital lesion groups demonstrated poor performance on stimuli presented to the ear contralateral to the lesion. In overall performance on speech discrimination, however, the left-hemisphere congenital lesion group performed significantly better than the acquired-lesion group did. On complex-pitch discrimination, the right-hemisphere congenital lesion group performed significantly better than did the acquired-lesion group, but both left- and right-hemisphere congenital lesion groups were significantly worse at complex-pitch discrimination than were their age- and gender-matched normal controls. These results indicate that although congenital damage produces a "lesion effect" in dichotic listening similar to that after damage acquired in adulthood, overall function is relatively spared. To the extent that complex-pitch discrimination is affected by congenital damage to either hemisphere but speech discrimination is not, the present results are consistent with an asymmetric form of crowding during reorganization after congenital unilateral brain damage.
我们评估了9例产前(先天性)单侧左半球损伤的年轻患者和8例单侧右半球损伤的年轻患者的双耳分听和复音辨别能力。与后天性单侧损伤的成年人一样,两个先天性损伤组在损伤对侧耳朵所呈现刺激的测试中表现不佳。然而,在言语辨别总体表现上,先天性左半球损伤组的表现明显优于后天性损伤组。在复音辨别方面,先天性右半球损伤组的表现明显优于后天性损伤组,但先天性左半球和右半球损伤组在复音辨别上均明显差于年龄和性别匹配的正常对照组。这些结果表明,尽管先天性损伤在双耳分听中产生了类似于成年后获得性损伤后的“损伤效应”,但总体功能相对保留。就复音辨别受先天性单侧脑损伤后重组过程中不对称拥挤形式的影响,而言语辨别不受影响的程度来说,目前的结果是一致的。