Gasparini F M, Cohen L, Lopes M, Denvil D, Capelle L, Duffau H, Van Effenterre R
Service de Neurochirurgie, Groupe Hospitalier de la Pitié-Salpêtriére, Paris.
Rev Neurol (Paris). 2005 Apr;161(4):427-35. doi: 10.1016/s0035-3787(05)85072-6.
An increasing number of studies are focusing on the anatomo-functional organisation of number processing and some cognitive models have been recently developed. Nevertheless, relationships between areas implicated in number processing, and language areas and circuits remain unclear. Recently, Dehaene and Cohen, in their "triple-code model of number processing", (Dehaene and Cohen, 1995) distinguished two alternative number representation and processing systems: one depending on verbal processes, the other representing a quantity manipulation. According to this model, the retrieval of "arithmetical facts" (AF), learned by rote at school and memorised in a verbal form (such as the multiplication table or simple addition problems) can be considered as a verbal automatism; conversely, subtraction problems, which require mental manipulation of the quantities, represent an abstract, semantic elaboration: "Actual Calculation" (AC). The anatomical correlate of the retrieval of AF (depending on automatic verbal associations) seems to correspond to the left-hemispheric perisylvian areas, while impairment of the actual calculation (AC) depends on the intraparietal region, particularly in the left dominant hemisphere. The present study describes the neuropsychological assessment of three patients, tested after surgery for left parieto-occipital tumors. Two of them were affected by an anaplasic glioma, the third by a low-grade glioma. The cognitive evaluation included: words of Rey, numeral (directed and reversed) span, reading of "simple" numbers (from 1 to 10) and of "complex" numbers (many decimals), writing (dictation) and reading a standard text, finger denomination and right-left distinction. All patients showed language disturbances, dysgraphia and severe dyslexia. In reading numbers, we identified two types of errors: lexical and syntactic. "Lexical errors" consisted in a wrong choice among words in the number's lexicon. For instance, all patients made errors in reading "complex" numbers composed by many decimals, switching single numbers but respecting the decimal size and the structure of the whole number (such as 69107 instead of 68107). On the other hand, only one patient committed syntactic errors, misunderstanding the decimal size and the structure of the number. We considered lexical errors as verbal errors, and syntactic errors as semantic errors, affecting the notion of quantity. We tried to explain verbal disturbances as well as lexical errors as a consequence of lesion of the left-hemispheric perisylvian areas, while syntactic errors as a consequence of impairment of the intraparietal region.
越来越多的研究聚焦于数字处理的解剖功能组织，并且最近已经开发了一些认知模型。然而，涉及数字处理的区域与语言区域和神经回路之间的关系仍不明确。最近，德阿纳和科恩在他们的“数字处理三代码模型”（德阿纳和科恩，1995年）中区分了两种不同的数字表征和处理系统：一种依赖于语言过程，另一种代表数量操作。根据这个模型，通过在学校死记硬背并以语言形式记忆的“算术事实”（AF）（如乘法表或简单加法问题）的检索可以被视为一种语言自动化；相反，需要对数量进行心理操作的减法问题则代表一种抽象的语义加工：“实际计算”（AC）。AF检索（依赖于自动语言联想）的解剖学相关区域似乎对应于左半球的颞叶周围区域，而实际计算（AC）的损伤则取决于顶内区域，特别是在左优势半球。本研究描述了三名患者在接受左顶枕部肿瘤手术后的神经心理学评估。其中两名患者患有间变性胶质瘤，第三名患者患有低级别胶质瘤。认知评估包括：雷氏词语、数字（顺背和倒背）广度、“简单”数字（从1到10）和“复杂”数字（多位小数）的阅读、书写（听写）和标准文本的阅读、手指命名和左右区分。所有患者均表现出语言障碍、书写障碍和严重诵读困难。在数字阅读方面，我们识别出两种错误类型：词汇错误和句法错误。“词汇错误”在于在数字词汇中选错单词。例如，所有患者在阅读由多位小数组成的“复杂”数字时都犯了错误，单个数字交换但保留了小数大小和整个数字的结构（如69107而不是68107）。另一方面，只有一名患者犯了句法错误，误解了数字的小数大小和结构。我们将词汇错误视为语言错误，将句法错误视为语义错误，影响数量概念。我们试图将语言障碍以及词汇错误解释为左半球颞叶周围区域损伤的结果，而将句法错误解释为顶内区域损伤的结果。
