Haaland Kathleen Y, Prestopnik Jillian L, Knight Robert T, Lee Roland R
Behavioral Healthcare Line, New Mexico VA Healthcare System, Albuquerque, NM 87108, USA.
Brain. 2004 May;127(Pt 5):1145-58. doi: 10.1093/brain/awh133. Epub 2004 Mar 19.
Kinematic analyses of reaching have suggested that the left hemisphere is dominant for controlling the open loop component of the movement, which is more dependent on motor programmes; and the right hemisphere is dominant for controlling the closed loop component, which is more dependent on sensory feedback. This open and closed loop hypothesis of hemispheric asymmetry would also predict that advance planning should be dependent on the left hemisphere, and on-line response modification, which defines closed loop processes, should be dependent on the right hemisphere. Using kinematic analyses of reaching in patients with left or right hemisphere damage (LHD or RHD), we examined the ability: (i) to plan reaching movements in advance by examining changes in reaction time (RT) when response amplitude and visual feedback were cued prior to the response; and (ii) to modify the response during implementation when target location changed at the RT. Performance was compared between the stroke groups, using the ipsilesional arm, and age-matched control groups using their right (RNC) or left (LNC) arm. Aiming movements to a target that moved once or twice, with the second step occurring at the RT, were performed with or without visual feedback of hand position. There were no deficits in advance planning in either stroke group, as evidenced by comparable group changes in RT with changes in amplitude and visual feedback. Response modification deficits were seen for the LHD group in secondary velocity only. In addition, LHD produced slower initial peak velocity with prolongation of the deceleration phase and faster secondary peak velocities, and the RHD group produced deficits in final error only. These differences are more consistent with the dynamic dominance hypothesis, which links left hemisphere specialization to movement trajectory control and right hemisphere specialization to position control, rather than to global deficits in open and closed loop processing.
对伸手动作的运动学分析表明,左半球在控制运动的开环部分方面占主导地位,该部分更依赖于运动程序;而右半球在控制闭环部分方面占主导地位,该部分更依赖于感觉反馈。这种半球不对称的开环和闭环假说还预测,提前规划应依赖于左半球,而定义闭环过程的在线反应修正应依赖于右半球。通过对左半球或右半球损伤患者(左半球损伤或右半球损伤)伸手动作的运动学分析,我们检验了以下能力:(i)通过在反应前提示反应幅度和视觉反馈时检查反应时间(RT)的变化来提前规划伸手动作;(ii)当目标位置在反应时间发生变化时,在执行过程中修改反应。使用患侧手臂,将中风组与年龄匹配的使用右手(右正常对照组)或左手(左正常对照组)的对照组进行表现比较。在有或没有手部位置视觉反馈的情况下,对一个目标进行一到两次移动的瞄准动作,第二步在反应时间发生。两个中风组在提前规划方面均无缺陷,反应时间随幅度和视觉反馈变化的组间变化具有可比性即可证明。仅在次要速度方面,左半球损伤组出现反应修正缺陷。此外,左半球损伤导致初始峰值速度较慢,减速期延长,次要峰值速度较快,而右半球损伤组仅在最终误差方面存在缺陷。这些差异与动态优势假说更为一致,该假说将左半球特化与运动轨迹控制联系起来,将右半球特化与位置控制联系起来,而不是与开环和闭环处理的整体缺陷联系起来。