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中风后肢体失用症患者感觉运动整合的时间窗口扭曲,而能动性感知的时间窗口保留。

Distorted time window for sensorimotor integration and preserved time window for sense of agency in patients with post-stroke limb apraxia.

作者信息

Nobusako Satoshi, Ishibashi Rintaro, Maeda Takaki, Shimada Sotaro, Morioka Shu

机构信息

Neurorehabilitation Research Center, Kio University, Nara, Japan.

Graduate School of Health Science, Kio University, Nara, Japan.

出版信息

Front Hum Neurosci. 2025 Jun 13;19:1597200. doi: 10.3389/fnhum.2025.1597200. eCollection 2025.

Abstract

Limb apraxia is a cognitive-motor disorder typically resulting from left hemisphere stroke, characterized by an inability to perform skilled limb movements despite intact motor and sensory functions. Previous studies suggest that individuals with apraxia exhibit deficits in sensorimotor integration, particularly in detecting temporal discrepancies between movement and sensory feedback. However, whether these deficits affect explicit sense of agency (SoA) remains unclear. This study investigated the time window for sensorimotor integration and explicit SoA in post-stroke patients with and without apraxia. Twenty patients with left hemisphere stroke participated in a delay detection task assessing sensory-sensory and sensorimotor integration and an agency attribution task measuring explicit SoA. The results demonstrated that apraxic patients had a significantly prolonged delay detection threshold and reduced steepness in the active movement condition, indicating an altered time window for sensorimotor integration. In contrast, there were no significant differences between apraxic and non-apraxic patients in the time window for explicit SoA. These findings suggest that while apraxic patients exhibit deficits in sensorimotor integration, their explicit SoA remains preserved. This dissociation supports the notion that explicit SoA may be maintained through compensatory cognitive processes despite impairments at the sensorimotor level. Further research is needed, considering the limitations of this study, to achieve a more comprehensive understanding of SoA in apraxia.

摘要

肢体失用症是一种认知运动障碍,通常由左半球中风引起,其特征是尽管运动和感觉功能完好,但仍无法进行熟练的肢体运动。先前的研究表明,患有失用症的个体在感觉运动整合方面存在缺陷,尤其是在检测运动与感觉反馈之间的时间差异方面。然而,这些缺陷是否会影响明确的能动感(SoA)仍不清楚。本研究调查了有和没有失用症的中风后患者的感觉运动整合时间窗口和明确的SoA。20名左半球中风患者参与了一项延迟检测任务,该任务评估感觉-感觉和感觉运动整合,以及一项能动归因任务,测量明确的SoA。结果表明,失用症患者在主动运动条件下的延迟检测阈值显著延长,陡度降低,表明感觉运动整合的时间窗口发生了改变。相比之下,失用症患者和非失用症患者在明确的SoA时间窗口上没有显著差异。这些发现表明,虽然失用症患者在感觉运动整合方面存在缺陷,但其明确的SoA仍然保留。这种分离支持了这样一种观点,即尽管在感觉运动水平存在损伤,但明确的SoA可能通过代偿性认知过程得以维持。考虑到本研究的局限性,需要进一步研究以更全面地了解失用症中的SoA。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16aa/12202472/f4bca7b5cdae/fnhum-19-1597200-g001.jpg

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