Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Ashikaga, Japan.
Department of Rehabilitation, Edogawa Hospital, Tokyo, Japan.
Cogn Behav Neurol. 2024 Jun 1;37(2):82-95. doi: 10.1097/WNN.0000000000000369.
Individuals with acquired brain injury have reported subjective complaints of depth perception deficits, but few have undergone objective assessments to confirm these deficits. As a result, the literature currently lacks reports detailing the correlation between subjective depth perception deficits and objective stereoscopic vision deficits in individuals with acquired brain injury, particularly those cases that are characterized by a clearly defined lesion. To investigate this relationship, we recruited three individuals with acquired brain injury who experienced depth perception deficits and related difficulties in their daily lives. We had them take neurologic, ophthalmological, and neuropsychological examinations. We also had them take two types of stereoscopic vision tests: a Howard-Dolman-type stereoscopic vision test and the Topcon New Objective Stereo Test. Then, we compared the results with those of two control groups: a group with damage to the right hemisphere of the brain and a group of healthy controls. Performance on the two stereoscopic vision tests was severely impaired in the three patients. One of the patients also presented with cerebral diplopia. We identified the potential neural basis of these deficits in the cuneus and the posterior section of the superior parietal lobule, which play a role in vergence fusion and are located in the caudal region of the dorso-dorsal visual pathway, which is known to be crucial not only for visual spatial perception, but also for reaching, grasping, and making hand postures in the further course of that pathway.
脑损伤患者报告存在深度知觉缺陷的主观抱怨,但很少有患者接受过客观评估来确认这些缺陷。因此,目前文献缺乏详细描述脑损伤患者(特别是那些具有明确病灶的患者)主观深度知觉缺陷与客观立体视觉缺陷之间相关性的报告。为了研究这种关系,我们招募了三名脑损伤患者,他们都存在深度知觉缺陷,并在日常生活中遇到相关困难。我们对他们进行了神经学、眼科和神经心理学检查。我们还让他们接受了两种类型的立体视觉测试:Howard-Dolman 型立体视觉测试和 Topcon 新型客观立体测试。然后,我们将结果与两个对照组进行比较:一个是右脑损伤组,另一个是健康对照组。在这三名患者中,两种立体视觉测试的表现都严重受损。其中一名患者还出现了复视。我们在楔叶和上顶叶后部发现了这些缺陷的潜在神经基础,它们在聚散融合中起作用,位于背-背视觉通路的尾部,该通路不仅对视觉空间感知至关重要,而且在该通路的进一步过程中对伸手、抓握和手部姿势也很重要。