Lee Byung Hwa, Suh Mee Kyung, Kim Eun-Joo, Seo Sang Won, Choi Kyung Mook, Kim Gyeong-Moon, Chung Chin-Sang, Heilman Kenneth M, Na Duk L
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-gu, Seoul 135-710, Republic of Korea.
Neuropsychologia. 2009 Feb;47(3):704-10. doi: 10.1016/j.neuropsychologia.2008.11.027. Epub 2008 Nov 30.
Patients with right hemisphere injury often omit or misread words on the left side of a page or the beginning letters of single words (neglect dyslexia). Our study involving a large sample of acute right hemisphere stroke investigated (1) the frequency of neglect dyslexia (ND), (2) the association between ND and other types of contralesional hemispatial neglect (CN), (3) the effect of visual field defect (VFD) on ND, and (4) the anatomical substrates for ND. Participants were 138 consecutive patients with right hemisphere stroke who underwent a neglect test battery including a test for ND. ND was considered present if the patient misread or omitted the left portion of the word in three or more of the 25 target words. CN was noted in 80/138 (58.0%) patients while ND was found in 31/138 (22.5%) patients. Of the 80 patients with CN, the frequency of neglect based on ND test was only 37.5% while the frequency of neglect based on other neglect tasks ranged from 51.3% to 86.3%. The severity of neglect was a significant predictor for ND. VFD was also a significant predictor for the occurrence of ND but this effect disappeared when the severity of neglect was controlled. Patients with CN had lesions in the superior and middle temporal gyri, inferior parietal lobule, and posterior insular cortex; patients with ND had additional lesions in the lingual and fusiform gyri. In summary, ND was dissociated from other types of neglect and was most often associated with severe neglect. VFD contributed to the occurrence of ND. ND resulted from lesions of temporoparietal junction areas (inferior parietal/superior temporal gyri) combined with those of lingual/fusiform gyri.
右半球损伤的患者常常会遗漏或误读书页左侧的单词或单个单词的首字母（疏忽性失读症）。我们的研究纳入了大量急性右半球卒中患者样本，调查了：（1）疏忽性失读症（ND）的发生率；（2）ND与其他类型对侧半空间疏忽（CN）之间的关联；（3）视野缺损（VFD）对ND的影响；以及（4）ND的解剖学基础。研究对象为138例连续的右半球卒中患者，他们接受了包括ND测试在内的一系列疏忽测试。如果患者在25个目标单词中的3个或更多单词中误读或遗漏了单词的左侧部分，则认为存在ND。80/138（58.0%）例患者存在CN，而31/138（22.5%）例患者存在ND。在80例有CN的患者中，基于ND测试的疏忽发生率仅为37.5%，而基于其他疏忽任务的疏忽发生率在51.3%至86.3%之间。疏忽的严重程度是ND的显著预测因素。VFD也是ND发生的显著预测因素，但在控制了疏忽的严重程度后，这种影响消失了。有CN的患者在颞上回、颞中回、顶下小叶和岛叶后皮质有病变；有ND的患者在舌回和梭状回还有额外病变。总之，ND与其他类型的疏忽不同，且最常与严重疏忽相关。VFD促成了ND的发生。ND是由颞顶叶交界区（顶下小叶/颞上回）病变与舌回/梭状回病变共同导致的。
