Caselli R J
Section of Neurology, Mayo Clinic Scottsdale, AZ 85259.
Neurology. 1993 Apr;43(4):762-71. doi: 10.1212/wnl.43.4.762.
Five somatosensory cortices have distinctive somatotopic representations, cytoarchitecture, and connectivity: primary somatosensory cortex (SI), ventrolateral association cortices (SII, SIII, and SIV), and dorsomedial association cortex (supplementary sensory area). Patients with focal lesions of ventrolateral (n = 5) and dorsomedial (n = 6) somatosensory association cortices (SACs) and hemiparetic (n = 8) and neurologically normal control patients (n = 14) underwent detailed somesthetic testing that encompassed basic, intermediate, and complex (tactile object recognition) somesthetic functions. Dorsomedial lesions acutely caused severe disruption of somesthetic processing and severe apraxia when the area of damage was extensive and involved anterior and posterior cortices. In contrast, ventrolateral lesions caused tactile agnosia. Chronically, sensorimotor function following dorsomedial damage improved considerably. Tactile agnosia following ventrolateral damage, however, was readily detectable for years following onset. Functional differences between ventrolateral and dorsomedial SACs may reflect parallel processing in dual somatosensory systems.
五个躯体感觉皮层具有独特的躯体定位表征、细胞结构和连接性：初级躯体感觉皮层（SI）、腹外侧联合皮层（SII、SIII和SIV）以及背内侧联合皮层（辅助感觉区）。对腹外侧（n = 5）和背内侧（n = 6）躯体感觉联合皮层（SACs）局灶性病变的患者以及偏瘫患者（n = 8）和神经功能正常的对照患者（n = 14）进行了详细的躯体感觉测试，该测试涵盖了基本、中级和复杂（触觉物体识别）躯体感觉功能。当背内侧病变面积广泛且累及前后皮层时，会急性导致躯体感觉处理的严重紊乱和严重失用症。相比之下，腹外侧病变会导致触觉失认症。长期来看，背内侧损伤后的感觉运动功能有显著改善。然而，腹外侧损伤后的触觉失认症在发病数年后仍很容易被检测到。腹外侧和背内侧SACs之间的功能差异可能反映了双躯体感觉系统中的并行处理。
