Gainotti G
Institute of Neurology of the Catholic University/Policlinico Gemelli Largo A. Gemelli, Roma, Italy.
Neurosci Biobehav Rev. 1996 Winter;20(4):617-22. doi: 10.1016/0149-7634(95)00074-7.
Unilateral Spatial Neglect (USN) can be considered as a defect in spatial orienting of attention toward the half space contralateral to the damaged hemisphere. Since the classical work of Brain, W.R. Brain 64:224-272 (1941), several authors have emphasized that this defect is definitely more frequent and severe in patients with right brain damage, but the reason for this hemispheric asymmetry has remained controversial. Several investigations conducted with different experimental paradigms in different laboratories have shown that only automatic orienting of attention toward stimuli arising in the half space contralateral to the damaged hemisphere is disrupted in USN, whereas controlled, volitional orienting can be more or less completely spared. The hypothesis that at the level of the right hemisphere, spatial orienting of attention may be mainly prompted by automatic mechanisms may, therefore, be advanced. By contrast, the left hemisphere might play a leading role in mechanisms underlying volitional orienting of attention. According to this model, recovery from USN could be due to substitution of the lost automatic orienting mechanisms with the spread volitional orienting mechanisms subserved by the intact left hemisphere.
单侧空间忽视（USN）可被视为一种注意力向受损半球对侧半空间进行空间定向的缺陷。自布雷恩（W.R. Brain）的经典著作（《大脑》64:224 - 272，1941年）以来，几位作者强调这种缺陷在右脑损伤患者中肯定更为常见和严重，但这种半球不对称的原因仍存在争议。在不同实验室采用不同实验范式进行的多项研究表明，在单侧空间忽视中，只有注意力向受损半球对侧半空间出现的刺激的自动定向受到干扰，而控制性的、有意的定向或多或少可以完全保留。因此，可以提出这样的假设：在右半球水平，注意力的空间定向可能主要由自动机制引发。相比之下，左半球可能在注意力有意定向的潜在机制中起主导作用。根据这个模型，单侧空间忽视的恢复可能是由于完整的左半球所支持的扩展的有意定向机制替代了丧失的自动定向机制。
