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早期脑损伤后的视觉系统可塑性。

Plasticity of the visual system after early brain damage.

机构信息

Department of Developmental Neuroscience, Stella Maris Scientific Institute, Pisa, Italy.

出版信息

Dev Med Child Neurol. 2010 Oct;52(10):891-900. doi: 10.1111/j.1469-8749.2010.03710.x. Epub 2010 Jun 15.

Abstract

The aim of this review is to discuss the existing evidence supporting different processes of visual brain plasticity after early damage, as opposed to damage that occurs during adulthood. There is initial evidence that some of the neuroplastic mechanisms adopted by the brain after early damage to the visual system are unavailable at a later stage. These are, for example, the ability to differentiate functional tissue within a larger dysplastic cortex during its formation, or to develop new thalamo-cortical connections able to bypass the lesion and reach their cortical destination in the occipital cortex. The young brain also uses the same mechanisms available at later stages of development but in a more efficient way. For example, in people with visual field defects of central origin, the anatomical expansion of the extrastriatal visual network is greater after an early lesion than after a later one, which results in more efficient mechanisms of visual exploration of the blind field. A similar mechanism is likely to support some of the differences found in people with blindsight, the phenomenon of unconscious visual perception in the blind field. In particular, compared with people with late lesions, those with early brain damage appear to have stronger subjective awareness of stimuli hitting the blind visual field, reported as a conscious feeling that something is present in the visual field. Expanding our knowledge of these mechanisms could help the development of early therapeutic interventions aimed at supporting and enhancing visual reorganization at a time of greatest potential brain plasticity.

摘要

本综述旨在讨论现有的证据,支持早期视觉损伤后与成年后损伤不同的视觉大脑可塑性过程。有初步证据表明,大脑在早期视觉系统损伤后采用的一些神经可塑性机制在以后的阶段是不可用的。例如,在形成过程中区分较大发育不良皮质内功能组织的能力,或发展新的丘脑皮质连接,能够绕过病变并到达其在枕叶皮质的皮质目的地。年轻的大脑也使用在发育后期可用的相同机制,但更有效。例如,在具有中央起源的视野缺陷的人中,早期病变后,位于纹状体外的视觉网络的解剖扩张比晚期病变后更大,这导致对盲点进行更有效的视觉探索机制。类似的机制可能支持在盲视人群中发现的一些差异,即盲视现象,即无意识地感知盲点中的视觉。特别是与晚期损伤的人相比,早期大脑损伤的人似乎对击中盲点的刺激有更强的主观意识,表现为一种有意识的感觉,即视野中存在某物。扩大我们对这些机制的认识可能有助于发展早期治疗干预措施,以在大脑具有最大潜在可塑性的时期支持和增强视觉重组。

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