Kim Eun-Joo, Lee Byung Hwa, Park Key Chung, Suh Mee Kyung, Ku Bon D, Heilman Kenneth M, Na Duk L
Department of Neurology, Pusan National University School of Medicine and Medical Research Institute, Busan, Korea.
Cogn Behav Neurol. 2009 Jun;22(2):122-6. doi: 10.1097/WNN.0b013e3181a7227f.
Patients with neglect often repeatedly cancel the same targets, a form of motor perseveration (MP). There seems to be 2 types of MP, making uninterrupted multiple strokes for each target, consecutive MP (CMP) or return MP (RMP) where patients return to previously canceled targets and remark them.
The purpose of this study is to learn whether these 2 forms of MP are dissociable.
We studied 3 patients, 1 with primarily CMP, another with primarily RMP and a third with mixed CMP and RMP by having them perform the cancellation task with and without background movement.
In the patient with primarily RMPs (patient 1), leftward background movement decreased the severity of the neglect and the perseveration. Rightward background movement increased both. In contrast to patient 1, who showed the correspondence between the severity of neglect and perseveration, the patient with both CMP and RMP (patient 2) and the patient with primarily CMPs (patient 3) did not show such correspondence.
The different responses of CMP and RMP to the treatment of neglect suggest that different mechanisms account for these 2 forms of MP. Although RMP might be related to neglect induced aberrant approach behaviors, CMP seems to be related to a disengagement disorder.
忽视症患者常常反复取消相同目标,这是一种运动持续性(MP)形式。似乎存在两种类型的MP,即对每个目标进行不间断的多次划消,连续MP(CMP)或返回MP(RMP),后者指患者返回先前取消的目标并重新标记它们。
本研究旨在了解这两种MP形式是否可分离。
我们研究了3例患者,1例主要表现为CMP,另1例主要表现为RMP,第3例表现为CMP和RMP混合形式,让他们在有和没有背景运动的情况下执行划消任务。
在主要表现为RMP的患者(患者1)中,向左的背景运动降低了忽视和持续性的严重程度。向右的背景运动则使其均增加。与显示忽视严重程度和持续性之间存在对应关系的患者1不同,同时具有CMP和RMP的患者(患者2)以及主要表现为CMP的患者(患者3)未显示出这种对应关系。
CMP和RMP对忽视治疗的不同反应表明,这两种MP形式由不同机制所致。虽然RMP可能与忽视引起的异常趋近行为有关,但CMP似乎与脱离障碍有关。