Department of Neurology, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
Annu Rev Neurosci. 2011;34:569-99. doi: 10.1146/annurev-neuro-061010-113731.
Unilateral spatial neglect is a common neurological syndrome following predominantly right hemisphere injuries and is characterized by both spatial and non-spatial deficits. Core spatial deficits involve mechanisms for saliency coding, spatial attention, and short-term memory and occur in conjunction with nonspatial deficits that involve reorienting, target detection, and arousal/vigilance. We argue that neglect is better explained by the dysfunction of distributed cortical networks for the control of attention than by structural damage of specific brain regions. Ventral lesions in right parietal, temporal, and frontal cortex that cause neglect directly impair nonspatial functions partly mediated by a ventral frontoparietal attention network. Structural damage in ventral cortex also induces physiological abnormalities of task-evoked activity and functional connectivity in a dorsal frontoparietal network that controls spatial attention. The anatomy and right hemisphere dominance of neglect follow from the anatomy and laterality of the ventral regions that interact with the dorsal attention network.
单侧空间忽略是一种常见的神经综合征,主要发生于右半球损伤后,其特征为空间和非空间缺陷。核心空间缺陷涉及突显编码、空间注意和短期记忆的机制,与涉及重新定向、目标检测和唤醒/警觉的非空间缺陷同时发生。我们认为,忽略现象更好地用注意力控制的分布式皮质网络功能障碍来解释,而不是用特定脑区的结构性损伤来解释。右顶叶、颞叶和额叶皮质的腹侧损伤导致忽略,直接损害了部分由腹侧额顶叶注意力网络介导的非空间功能。腹侧皮质的结构性损伤还会导致控制空间注意力的背侧额顶叶网络中任务诱发活动和功能连接的生理异常。忽略的解剖结构和右半球优势源于与背侧注意力网络相互作用的腹侧区域的解剖结构和偏侧性。