Medical Centre for the Ageing-Memory Clinic, Catholic University, Rome, Italy.
Neuropsychology. 2011 Sep;25(5):554-66. doi: 10.1037/a0023957.
In an attempt to interpret neglect as a disconnection syndrome, it is currently proposed that the disorder results from disorganization of large-scale networks involved in attentional spatial processes rather than of individual brain areas. We hypothesize that as degenerative brain diseases are "system pathologies," degeneration could be restricted to some of the neural subsystems implicated in the functional organization of spatial attention and different neglect syndromes could emerge depending on the patterns of the subsystems involved.
We studied five neglect patients: one with corticobasal degeneration (CBD), three with Posterior Cortical Atrophy (PCA) and one with frontotemporal dementia (FTD).
The patient with CBD and left parietoccipital atrophy showed right allocentric neglect; the three patients with PCA mostly distributed in the right posterior regions showed left egocentric extrapersonal neglect; the patient with FTD, who displayed more severe frontotemporal atrophy on the right, had left motor-executive neglect for both personal and extrapersonal space. All patients also presented a deep breakdown of spatial working memory.
Our data would confirm that left neglect is more frequent than right neglect also in degenerative pathology and that damage to different neural substrates can produce different types of neglect. Our findings are also consistent with the hypothesis that both lateralized and nonlateralized attention disorders contribute to generate the syndrome. We suggest that evidence from degenerative diseases may contribute to construction of models of spatial attention.
为了解释忽视是一种连接综合征，目前提出这种障碍是由于参与注意力空间过程的大规模网络的组织紊乱而不是单个脑区的紊乱所致。我们假设，由于退行性脑疾病是“系统性疾病”，退化可能仅局限于涉及空间注意力功能组织的一些神经子系统，并且不同的忽视综合征可能会根据涉及的子系统的模式而出现。
我们研究了五名忽视症患者：一名皮质基底节变性（CBD）患者，三名后部皮质萎缩（PCA）患者和一名额颞叶痴呆（FTD）患者。
CBD 患者和左顶枕部萎缩患者表现为右侧空间忽视；三个主要分布在右后区域的 PCA 患者表现为左侧自我中心的体外忽视；右侧额颞叶萎缩更严重的 FTD 患者对个人和体外空间都有左运动执行忽视。所有患者的空间工作记忆也严重受损。
我们的数据将证实，在退行性病变中，左忽视也比右忽视更常见，并且不同的神经基底损伤可以产生不同类型的忽视。我们的发现也与以下假设一致，即偏侧和非偏侧注意障碍有助于产生综合征。我们建议，退行性疾病的证据可能有助于构建空间注意力模型。
