Hartmann Karoline, Goldenberg Georg, Daumüller Maike, Hermsdörfer Joachim
Neuropsychological Department, Bogenhausen Hospital, Englschalkingerstrasse 77, D 81925 Munich, Germany.
Neuropsychologia. 2005;43(4):625-37. doi: 10.1016/j.neuropsychologia.2004.07.015.
Left hemisphere dominance has been established for use of single familiar tools and tool/object pairs, but everyday action in natural environment frequently affords multi-step actions with more or less novel technical devices. One purpose of our study was to find out whether left hemisphere dominance extends to such naturalistic action. Another aim was to analyze the cognitive components contributing to success or failure. Patients with LBD and aphasia, patients with RBD, and healthy controls were examined on experimental tests assessing retrieval of functional knowledge from semantic memory, inference of function from structure, and solution of mechanical and non-mechanical multi-step problems, and were confronted with two naturalistic tasks involving technical devices: preparing coffee with a drip coffee maker and fixing a cassette recorder. Both patient groups were about equally impaired on both naturalistic actions. Analysis of the experimental tests and their correlations to naturalistic actions suggested that different cognitive deficits caused failure in both patient groups, and that in LBD patients there were also different causes for failure on both naturalistic actions. The main difficulty of RBD patients seemed to reside in the demand to keep track of multi-step actions. In aphasic LBD patients difficulties with making coffee but not the cassette recorder were correlated with aphasia and defective retrieval of functional knowledge from semantic memory, whereas the cassette recorder correlated more strongly with a test probing solution of multi-step mechanical problems. Inference of function from structure which had been shown to be important for use of single familiar tools or tool/objects pairs [Goldenberg, G., Hagmann, S. (1998). AT Tool use and mechanical problem solving in apraxia. Neuropsychologia, 36, 581-589] appeared to play only a subordinate role for naturalistic actions involving technical devices.
对于使用单个熟悉工具及工具/物体对而言，左半球优势已经确立，但在自然环境中的日常行动常常需要使用或多或少新颖的技术设备进行多步骤操作。我们研究的一个目的是弄清楚左半球优势是否扩展到此类自然主义行动。另一个目的是分析促成成功或失败的认知成分。对患有左侧脑损伤和失语症的患者、患有右侧脑损伤的患者以及健康对照者进行了实验测试，这些测试评估从语义记忆中检索功能知识、从结构推断功能以及解决机械和非机械多步骤问题的能力，并且让他们面对两项涉及技术设备的自然主义任务：用滴漏式咖啡机煮咖啡和修理盒式录音机。两个患者组在这两项自然主义行动上的受损程度大致相同。对实验测试及其与自然主义行动的相关性分析表明，不同的认知缺陷导致两个患者组均出现失败，并且在左侧脑损伤患者中，两项自然主义行动失败的原因也各不相同。右侧脑损伤患者的主要困难似乎在于需要跟踪多步骤行动。在失语的左侧脑损伤患者中，煮咖啡存在困难但修理盒式录音机不存在困难这一情况与失语症以及从语义记忆中检索功能知识存在缺陷相关，而修理盒式录音机与一项探测多步骤机械问题解决能力的测试相关性更强。从结构推断功能，这一功能已被证明对于使用单个熟悉工具或工具/物体对很重要[戈尔登贝格，G.，哈格曼，S.（1998年）。失用症中的工具使用和机械问题解决。《神经心理学》，36，581 - 589]，对于涉及技术设备的自然主义行动似乎仅起次要作用。
