Toraldo Alessio, Gandola Martina, Loffredo Simona, Rancati Anna, Zanardi Gabriele, Bottini Gabriella
International School for Advanced Studies, Trieste, Italy.
Brain Cogn. 2005 Apr;57(3):226-35. doi: 10.1016/j.bandc.2004.08.051.
Neglect patients typically show motor perseveration while canceling targets on the ipsilesional side. This behavior can be influenced by the presence vs. absence of targets on the (neglected) contralesional side (). As alternative explanations, the authors proposed (i) directional hypokinesia--the patient cannot perform reaching movements towards detected left-sided targets, and thus carries on canceling on the right side, and (ii) allochiria--the patient misperceives left-sided targets as located on the right side, and cancels them there. We report here data from a patient (EZ) that might confirm the second hypothesis. EZ was presented with 19 displays in which the number and position of cancellation targets on both sides were varied systematically. EZ showed motor perseveration while canceling, but this tendency did not vary across conditions. Interestingly though, EZ also drew cancellation marks in the empty space between the ipsilesional targets, and this phenomenon was significantly more intense when there were more targets on the neglected side. As EZ's comments suggested, such a behavior might reflect the attempt to cancel out delusional targets. Our speculation is that those objects were generated by allochiria.
忽视症患者在取消患侧目标时通常会表现出动作持续现象。这种行为会受到(被忽视的)对侧是否存在目标的影响()。作为替代性解释,作者提出了(i)定向运动减退——患者无法对检测到的左侧目标进行够取动作,因此继续在右侧进行取消操作;以及(ii)异手症——患者将左侧目标误感知为位于右侧,并在右侧将其取消。我们在此报告来自一名患者(EZ)的数据,这些数据可能证实了第二种假设。向EZ展示了19个画面,其中两侧取消目标的数量和位置都进行了系统变化。EZ在取消操作时表现出动作持续现象,但这种倾向在不同条件下并无变化。然而,有趣的是,EZ还在患侧目标之间的空白处绘制取消标记,当被忽视侧有更多目标时,这种现象明显更强烈。正如EZ的评论所表明的,这种行为可能反映了消除妄想目标的尝试。我们推测那些物体是由异手症产生的。