Dubois B, Malapani C, Verin M, Rogelet P, Deweer B, Pillon B
Fédération de Neurologie, Hôpital de la Salpêtrière, Paris.
Rev Neurol (Paris). 1994 Nov;150(11):763-70.
Cognitive changes have long been observed in patients with degenerative diseases or focal lesions that involve primarily subcortical structures. Generally speaking, the deficits that have been reported in these diseases are similar and include: slowing of central processing; defective use of memory stores; impaired behavioural regulation in sorting tasks; disorders of plaining in tower-related tasks; and impaired manipulation of internal representation of visuo-spatial stimuli. Given the modulatory role of the basal ganglia and related structures, these disorders might result from more fundamental deficits concerning the allocation of attentional resources, the temporal organization of behaviour, the maintenance of representations in working memory or the self-elaboration of internal strategy, all of which resemble dysfunctions of processes that are commonly considered to be controlled by the frontal lobes. This suggests a functional continuity between the basal ganglia and association areas of the prefrontal cortex. The recent description in primates of parallel, segregated loops that interconnect well-defined subregions of the basal ganglia to discrete areas of the prefrontal cortex via the thalamus may give some support to this hypothesis.
长期以来，人们在患有主要累及皮层下结构的退行性疾病或局灶性病变的患者中观察到认知变化。一般来说，这些疾病中报告的缺陷是相似的，包括：中枢处理速度减慢；记忆存储使用缺陷；分类任务中行为调节受损；与塔楼相关任务中的计划障碍；以及视觉空间刺激内部表征的操作受损。鉴于基底神经节及相关结构的调节作用，这些障碍可能源于更基本的缺陷，涉及注意力资源的分配、行为的时间组织、工作记忆中表征的维持或内部策略的自我完善，所有这些都类似于通常被认为由额叶控制的过程的功能障碍。这表明基底神经节与前额叶皮层联合区域之间存在功能连续性。最近在灵长类动物中描述的平行、分离的环路，通过丘脑将基底神经节的明确子区域与前额叶皮层的离散区域相互连接，可能为这一假设提供一些支持。
