Fiorelli M, Blin J, Bakchine S, Laplane D, Baron J C
Service Hospitalier Frédéric Joliot, Départment de Biologie, Orsay, France.
J Neurol Sci. 1991 Aug;104(2):135-42. doi: 10.1016/0022-510x(91)90302-n.
Six patients presenting with multimodal, predominantly motor hemi-neglect, were investigated by 15O2 or 18F-DG and PET to study the local cerebral metabolism in intact regions. All had suffered from an acute right-sided (n = 5) or left-sided (n = 1) focal hemispheric lesion (cortico-subcortical and purely subcortical in three patients each). Frontal and parietal cortices on the side of the lesion were significantly hypometabolic relative to the other side in each case, presumably as a result of diaschisis, whereas thalamic hypometabolism was significant in only 4 patients. Compared to absolute metabolic rates for controls, the uninjured hemisphere showed a trend towards hypometabolism. Hence, true hyperactivity of the contralateral hemisphere with respect to the ipsilateral cerebral cortex was not associated with motor hemineglect in this series. On the contrary, hemineglect was associated with a widespread hypometabolism of the entire ipsilateral cerebral cortex in the context of a moderately reduced metabolism of the ipsilateral thalamus and contralateral cerebral cortex. These findings are consistent with the implication of a cortico-subcortical network serving attention.
对6例以多模式、主要为运动性半侧忽视症状就诊的患者，采用(^{15}O_2)或(^{18}F-DG)及正电子发射断层扫描（PET）来研究完整区域的局部脑代谢。所有患者均患有急性右侧（(n = 5)）或左侧（(n = 1)）局灶性半球病变（3例为皮质 - 皮质下病变，3例为单纯皮质下病变）。在每种情况下，病变侧的额叶和顶叶皮质相对于另一侧均显著代谢减低，推测是由于交叉性小脑失联络所致，而仅4例患者丘脑代谢减低显著。与对照组的绝对代谢率相比，未受损半球有代谢减低的趋势。因此，在本系列中，对侧半球相对于同侧大脑皮质的真正活动增强与运动性半侧忽视无关。相反，在同侧丘脑和对侧大脑皮质代谢适度降低的情况下，半侧忽视与同侧整个大脑皮质广泛的代谢减低有关。这些发现与参与注意力的皮质 - 皮质下网络的作用相符。
