De Renzi E, Perani D, Carlesimo G A, Silveri M C, Fazio F
Clinica Neurologica, Università di Modena, Italy.
Neuropsychologia. 1994 Aug;32(8):893-902. doi: 10.1016/0028-3932(94)90041-8.
The early position that prosopagnosia is predominantly associated with right hemisphere (RH) injury was challenged by the finding that in practically all cases that come to autopsy pathological data point to bilateral damage. Yet the rejection of the RH hypothesis may have been too hasty. We report three prosopagnosic patients in whom MRI and CT documented a lesion confined to the right occipito-temporal areas and PET confirmed that hypometabolism involved the RH only. A review of the literature brought out 27 cases with neuroimaging evidence that prosopagnosia was associated with RH damage plus four cases with surgical evidence. It remains, however, that the inability to recognize familiar faces is a rare disorder, not manifested by the majority of patients with right temporo-occipital injury. We submit that right-handers differ in the degree of their RH specialization in processing faces and that in only a minority of them is it so marked that it cannot be compensated for by the healthy left hemisphere.
面孔失认症主要与右半球（RH）损伤相关这一早期观点受到了挑战，因为几乎所有进行尸检的病例的病理数据都表明是双侧损伤。然而，对RH假说的否定可能过于草率。我们报告了三名面孔失认症患者，他们的MRI和CT显示病变局限于右侧枕颞区，PET证实代谢减退仅累及RH。对文献的回顾发现了27例有神经影像学证据表明面孔失认症与RH损伤相关的病例，另外还有4例有手术证据的病例。然而，仍然存在的情况是，无法识别熟悉面孔是一种罕见的病症，大多数右侧颞枕叶损伤的患者并未表现出这种病症。我们认为，右利手者在处理面孔时其RH特化程度存在差异，只有少数人的这种特化程度非常明显，以至于健康的左半球无法对其进行代偿。
