Ten Brink Antonia F, Biesbroek J Matthijs, Oort Quirien, Visser-Meily Johanna M A, Nijboer Tanja C W
Center of Excellence in Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands; Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands.
Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
Behav Brain Res. 2019 Jan 1;356:504-515. doi: 10.1016/j.bbr.2018.06.010. Epub 2018 Jun 22.
Visuospatial neglect can occur in peripersonal and extrapersonal space. The dorsal visual pathway is hypothesized to be associated with peripersonal, and the ventral pathway with extrapersonal neglect. We aimed to evaluate neural substrates of peripersonal versus extrapersonal neglect, separately for egocentric and allocentric frames of reference.
This was a retrospective study, including stroke patients admitted for inpatient rehabilitation. Approximately 1 month post-stroke onset, computerized cancellation (egocentric) and bisection tasks (egocentric and allocentric) were administered at 30 cm and 120 cm. We collected CT or MRI scans and performed voxel-based lesion-symptom mapping for the cancellation, and subtraction analyses for the line bisection task.
We included 98 patients for the cancellation and 129 for the bisection analyses. The right parahippocampal gyrus, hippocampus, and thalamus were associated with egocentric peripersonal neglect as measured with cancellation. These areas were also associated with extrapersonal neglect, together with the right superior parietal lobule, angular gyrus, supramarginal gyrus, lateral occipital cortex, planum temporale and superior temporal gyrus. Lesions in the right parietal, temporal and frontal areas were associated with both peripersonal and extrapersonal egocentric neglect as measured with bisection. For allocentric neglect no clear pattern of associated brain regions was observed.
We found right hemispheric anatomical correlates for peripersonal and extrapersonal neglect. However, no brain areas were uniquely associated with peripersonal neglect, meaning we could not conclusively verify the ventral/dorsal hypothesis. Several areas were uniquely associated with egocentric extrapersonal neglect, suggesting that these brain areas can be specifically involved in extrapersonal, but not in peripersonal, attention processes.
视觉空间忽视可发生在个人周边空间和个人外部空间。据推测，背侧视觉通路与个人周边空间忽视相关，而腹侧通路与个人外部空间忽视相关。我们旨在分别针对以自我为中心和以他者为中心的参照系，评估个人周边空间忽视与个人外部空间忽视的神经基础。
这是一项回顾性研究，纳入因住院康复而入院的中风患者。在中风发病后约1个月，于30厘米和120厘米处进行计算机化划消任务（以自我为中心）和二等分任务（以自我为中心和以他者为中心）。我们收集了CT或MRI扫描图像，并对划消任务进行基于体素的病变-症状映射分析，对直线二等分任务进行减法分析。
我们纳入了98例进行划消任务分析的患者和129例进行二等分分析的患者。通过划消任务测量发现，右侧海马旁回、海马和丘脑与以自我为中心的个人周边空间忽视相关。这些区域还与个人外部空间忽视相关，同时还包括右侧顶上小叶、角回、缘上回、枕外侧皮质、颞平面和颞上回。通过二等分任务测量发现，右侧顶叶、颞叶和额叶区域的病变与以自我为中心的个人周边空间忽视和个人外部空间忽视均相关。对于以他者为中心的忽视，未观察到相关脑区的明确模式。
我们发现了与个人周边空间忽视和个人外部空间忽视相关的右侧半球解剖学关联。然而，没有脑区与个人周边空间忽视有独特关联，这意味着我们无法确凿地验证腹侧/背侧假说。有几个脑区与以自我为中心的个人外部空间忽视有独特关联，表明这些脑区可能特别参与个人外部而非个人周边的注意力过程。
