Department of Rehabilitation, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
Chin Med J (Engl). 2019 May 5;132(9):1063-1070. doi: 10.1097/CM9.0000000000000218.
Visual-spatial neglect (VSN) is a neuropsychological syndrome, and right-hemisphere stroke is the most common cause. The pathogenetic mechanism of VSN remains unclear. This study aimed to investigate the behavioral and event-related potential (ERP) changes in patients with or without VSN after right-hemisphere stroke.
Eleven patients with VSN with right-hemisphere stroke (VSN group) and 11 patients with non-VSN with right-hemisphere stroke (non-VSN group) were recruited along with one control group of 11 age- and gender-matched healthy participants. The visual-spatial function was evaluated using behavioral tests, and ERP examinations were performed.
The response times in the VSN and non-VSN groups were both prolonged compared with those of normal controls (P < 0.001). In response to either valid or invalid cues in the left side, the accuracy in the VSN group was lower than that in the non-VSN group (P < 0.001), and the accuracy in the non-VSN group was lower than that in controls (P < 0.05). The P1 latency in the VSN group was significantly longer than that in the control group (F[2, 30] = 5.494, P = 0.009), and the N1 amplitude in the VSN group was significantly lower than that in the control group (F[2, 30] = 4.343, P = 0.022). When responding to right targets, the left-hemisphere P300 amplitude in the VSN group was significantly lower than that in the control group (F[2, 30] = 4.255, P = 0.025). With either left or right stimuli, the bilateral-hemisphere P300 latencies in the VSN and non-VSN groups were both significantly prolonged (all P < 0.05), while the P300 latency did not differ significantly between the VSN and non-VSN groups (all P > 0.05).
Visual-spatial attention function is impaired after right-hemisphere stroke, and clinicians should be aware of the subclinical VSN. Our findings provide neuroelectrophysiological evidence for the lateralization of VSN.
视觉空间忽视（VSN）是一种神经心理学综合征，最常见的病因是右脑卒中。VSN 的发病机制仍不清楚。本研究旨在探讨右脑卒后伴有或不伴有 VSN 的患者的行为和事件相关电位（ERP）变化。
共纳入 11 例右脑卒后伴有 VSN 的患者（VSN 组）、11 例右脑卒后不伴有 VSN 的患者（非 VSN 组）和 11 例年龄和性别匹配的健康对照者（对照组）。采用行为测试评估视觉空间功能，进行 ERP 检查。
与对照组相比，VSN 组和非 VSN 组的反应时间均延长（均 P＜0.001）。在左侧有效或无效线索刺激时，VSN 组的准确性均低于非 VSN 组（均 P＜0.001），而非 VSN 组的准确性均低于对照组（均 P＜0.05）。VSN 组的 P1 潜伏期显著长于对照组（F[2, 30]＝5.494，P＝0.009），N1 振幅显著低于对照组（F[2, 30]＝4.343，P＝0.022）。当对右侧目标做出反应时，VSN 组左半球 P300 振幅显著低于对照组（F[2, 30]＝4.255，P＝0.025）。无论是左侧还是右侧刺激，VSN 组和非 VSN 组双侧半球的 P300 潜伏期均显著延长（均 P＜0.05），但 VSN 组和非 VSN 组的 P300 潜伏期无显著差异（均 P＞0.05）。
右脑卒后视觉空间注意力功能受损，临床医生应注意亚临床 VSN。本研究结果为 VSN 的偏侧化提供了神经电生理证据。
