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注意力与空间认知:视觉忽视的神经及解剖学基础

Attention and spatial cognition: Neural and anatomical substrates of visual neglect.

作者信息

Lunven Marine, Bartolomeo Paolo

机构信息

Inserm U1127, UPMC-Paris 6, CNRS UMR 7225, Brain and Spine Institute, Groupe Hospitalier Pitié-Salpêtrière, 75013 Paris, France; Inserm UMR_S 1028, CNRS UMR 5292, ImpAct, centre des neurosciences de Lyon, université Lyon-1, 69500 Bron, France.

Inserm U1127, UPMC-Paris 6, CNRS UMR 7225, Brain and Spine Institute, Groupe Hospitalier Pitié-Salpêtrière, 75013 Paris, France.

出版信息

Ann Phys Rehabil Med. 2017 Jun;60(3):124-129. doi: 10.1016/j.rehab.2016.01.004. Epub 2016 Feb 10.

Abstract

Unilateral spatial neglect (USN) is a neurological disorder often observed following damage to the right cerebral hemisphere. Patients with USN are no longer able to take into account stimuli presented on the left side of space. In this article, we will discuss the neuroanatomical correlates that underlie visuospatial attention and can cause USN, an area of growing research interest in the past 20 years. This syndrome has often been related to cortical damage, notably in the inferior parietal lobule. Other data have also implicated lesions in the inferior frontal gyrus or the superior temporal gyrus. In this article, we will highlight the relevance of viewing USN as a disconnection syndrome of interconnected cerebral areas, as opposed to a focal cortical syndrome. We will review data that provide evidence of intrahemispheric disconnection, in particular within the right hemisphere's frontoparietal networks connected by the superior longitudinal fasciculus. Recent findings suggest that interhemispheric disconnection could also contribute to the manifestations of USN. Most importantly, interhemispheric disconnection might be a predictive factor for the chronicity of this disorder. This hypothesis implies that the left hemisphere by itself is not able to compensate for the patients' deficits. Recovery requires the ability to exchange information between the two hemispheres, particularly in the posterior parietal and occipital regions.

摘要

单侧空间忽视(USN)是一种神经障碍,常在右侧大脑半球受损后出现。患有USN的患者不再能够考虑空间左侧呈现的刺激。在本文中,我们将讨论构成视觉空间注意力基础且可能导致USN的神经解剖学关联,这是过去20年来研究兴趣不断增长的一个领域。这种综合征常与皮质损伤有关,尤其是在顶下小叶。其他数据也表明额下回或颞上回存在病变。在本文中,我们将强调将USN视为相互连接的脑区的分离综合征的相关性,而不是局灶性皮质综合征。我们将回顾提供半球内分离证据的数据,特别是在由上纵束连接的右半球额顶网络内。最近的研究结果表明,半球间分离也可能导致USN的症状表现。最重要的是,半球间分离可能是这种疾病慢性化的一个预测因素。这一假设意味着左半球自身无法弥补患者的缺陷。恢复需要两个半球之间能够交换信息,特别是在顶叶后部和枕叶区域。

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