Hirstein William
Cognitive Science Laboratory,Elmhurst College, Elmhurst, IL 60126, USA.
Cogn Neuropsychiatry. 2010 Jan;15(1):233-60. doi: 10.1080/13546800903414891.
The patient with Capgras' syndrome claims that people very familiar to him have been replaced by impostors. I argue that this disorder is due to the destruction of a representation that the patient has of the mind of the familiar person. This creates the appearance of a familiar body and face, but without the familiar personality, beliefs, and thoughts. The posterior site of damage in Capgras' is often reported to be the temporoparietal junction, an area that has a role in the mindreading system, a connected system of cortical areas that allow us to attribute mental states to others. Just as the Capgras' patient claims that that man is not his father, the patient with asomatognosia claims that his arm is not really his. A similar account applies here, in that a nearby brain area, the supramarginal gyrus, is damaged. This area works in concert with the temporoparietal junction and other areas to produce a large representation of a mind inside a body situated in an environment. Damage to the mind-representing part of this system (coupled with damage to executive processes in the prefrontal lobes) causes Capgras' syndrome, whereas damage to the body-representing part of this system (also coupled with executive damage) causes asomatognosia.
患有卡普格拉综合征的患者声称,与他非常熟悉的人被冒名顶替者取代了。我认为这种障碍是由于患者对熟悉之人的心理表征遭到破坏所致。这就造成了熟悉的身体和面孔出现,但却没有了熟悉的个性、信念和思想。卡普格拉综合征患者受损的后部位置通常据报道是颞顶联合区,该区域在心理理论系统中发挥作用,心理理论系统是一个由多个皮质区域组成的相互关联的系统,使我们能够将心理状态归因于他人。正如卡普格拉综合征患者声称那个男人不是他的父亲一样,患有躯体失认症的患者声称他的手臂并非真的是他自己的。这里也适用类似的解释,即附近的脑区——缘上回——受到了损伤。该区域与颞顶联合区及其他区域协同工作,以构建一个处于特定环境中的身体内部的完整心理表征。该系统中代表心理的部分受损(再加上前额叶执行功能受损)会导致卡普格拉综合征,而该系统中代表身体的部分受损(同样伴有执行功能受损)则会导致躯体失认症。