Fazzi Elisa, Bova Stefania Maria, Uggetti Carla, Signorini Sabrina Giovanna, Bianchi Paolo Emilio, Maraucci Ilaria, Zoppello Marina, Lanzi Giovanni
Department of Child Neuropsychiatry, IRCSS C. Mondino Foundation, via Ferrata, 6, 27100 Pavia, Italy.
Brain Dev. 2004 Dec;26(8):506-12. doi: 10.1016/j.braindev.2004.02.002.
We set out to define visuo-perceptual impairment related to periventricular leukomalacia (PVL) using the Developmental Test of Visual Perception (DTVP). Correlations were sought between visual-perceptual deficits and DTVP profile and neuroradiological and neurophthalmological findings. The DTVP was administered to 20 children (m/f: 10/10), aged between 5 and 8 years (mean: 6.95 years), presenting with: spastic diplegia; PVL documented by brain MRI; normal or mildly impaired visual acuity; mild-moderate upper limb functional impairment. The mean General Visual-Perceptual Quotient was impaired, showing a great variability among the patients. Despite this, an uneven DTPV profile, characterised by a significant difference between the VMIQ and the Non-Motor Visual-Perceptual Quotient (P < 0.001) and a poor result on the Closure subtest (identification of whole figures from incomplete visual information) was observed in all the subjects. This profile reflects a deficit in eye-hand coordination and in praxic-constructional abilities and could be the expression of malfunctioning of the occipital-parietal pathway of visual integration, the so-called 'dorsal stream,' a hypothesis reinforced by the emergence of a statistically significant correlation between the neuroradiological data and the presence of visual-perceptual impairment.
我们着手使用视觉感知发育测试（DTVP）来定义与脑室周围白质软化症（PVL）相关的视觉感知障碍。我们探寻视觉感知缺陷与DTVP剖面图以及神经放射学和神经眼科检查结果之间的相关性。对20名年龄在5至8岁（平均6.95岁）的儿童（男/女：10/10）进行了DTVP测试，这些儿童表现为：痉挛性双侧瘫；脑部MRI显示有PVL；视力正常或轻度受损；轻度至中度上肢功能障碍。总体视觉感知商数均值受损，患者之间存在很大差异。尽管如此，在所有受试者中均观察到DTPV剖面图不均衡，其特征为视觉运动整合商数（VMIQ）与非运动视觉感知商数之间存在显著差异（P < 0.001），并且在闭合子测试（从不完整视觉信息中识别完整图形）中的结果较差。这种剖面图反映了眼手协调和实践构建能力方面的缺陷，可能是视觉整合枕顶叶通路（即所谓的“背侧流”）功能失调的表现，神经放射学数据与视觉感知障碍的存在之间出现统计学显著相关性这一情况进一步强化了这一假设。
