Laboratory of Anatomy and Organogenesis, University of Picardy Jules Verne, Amiens, France.
J Neurol. 2012 Sep;259(9):1860-7. doi: 10.1007/s00415-012-6421-x.
The aim of this study was to determine the neuropsychological consequences of a middle interhemispheric approach for the removal of tumors of the third or lateral ventricles. A retrospective analysis of eight callosotomized patients for ventricular tumors (three males/five females; mean age: 48.7 ± 11.2 years; education level: 11.9 ± 2.9 years) and eight healthy subjects was performed. An extensive neuropsychological test battery was used to evaluate global intellectual efficiency, memory capacities, executive functions, and interhemispheric transfer of a procedural learning task (serial reaction time task/SRTT). Neuropsychological results showed that: (1) five of eight patients operated through a middle transcallosal approach had disturbances of verbal or visual memory; (2) three of eight patients displayed a dysexecutive cognitive syndrome(two of eight of whom presenting with a deficit of verbal fluency); (3) two of eight patients presented a dysexecutive behavior syndrome; and (4) with regard to the SRTT, although all participants learned the task, in contrast to controls, the callosotomized patients showed an increase in reaction times and an absence of interhemispheric transfer of learning from one hand to the other. The transcallosal approach transects a large number of callosal fibers. This damage accounts for the deficits of memory, the dysexecutive cognitive and behavioral syndrome, and disturbances in interhemispheric transfer of learning.
本研究旨在确定经胼胝体中部入路切除第三脑室或外侧脑室肿瘤的神经心理学后果。对 8 例行胼胝体切开术治疗脑室肿瘤的患者(3 名男性/5 名女性;平均年龄:48.7 ± 11.2 岁;受教育程度:11.9 ± 2.9 年)和 8 名健康受试者进行了回顾性分析。采用广泛的神经心理学测试组合评估整体智力效率、记忆能力、执行功能以及程序性学习任务(序列反应时间任务/SRTT)的大脑两半球间转移。神经心理学结果显示:(1)8 名通过经胼胝体中部入路手术的患者中有 5 名存在言语或视觉记忆障碍;(2)8 名患者中有 3 名存在执行认知功能障碍综合征(其中 2 名存在言语流畅性缺陷);(3)8 名患者中有 2 名存在执行行为障碍综合征;(4)就 SRTT 而言,尽管所有参与者都学会了该任务,但与对照组相比,胼胝体切开患者的反应时间增加,并且学习从一只手到另一只手的大脑两半球间转移不存在。经胼胝体入路会横断大量胼胝体纤维。这种损伤导致记忆缺陷、执行认知和行为障碍综合征以及学习的大脑两半球间转移障碍。