Hirstein W, Ramachandran V S
Brain and Perception Laboratory, University of California, San Diego, La Jolla 92093, USA.
Proc Biol Sci. 1997 Mar 22;264(1380):437-44. doi: 10.1098/rspb.1997.0062.
Patients with Capgras syndrome regard people whom they know well such as their parents or siblings as imposters. Here we describe a case (DS) of this syndrome who presents several novel features. DS was unusual in that his delusion was modality-specific: he claimed that his parents were imposters when he was looking at them but not when speaking to them on the telephone. Unlike normals, DS's skin conductance responses to photographs of familiar people, including his parents, were not larger in magnitude than his responses to photographs of unfamiliar people. We suggest that in this patient connections from face-processing areas in the temporal lobe to the limbic system have been damaged, a loss which may explain why he calls his parents imposters. In addition, DS was very poor at judging gaze direction. Finally, when presented with a sequence of photographs of the same model's face looking in different directions, DS asserted that they were "different women who looked just like each other'. In the absence of limbic activation, DS creates separate memory "files' of the same person, apparently because he is unable to extract and link the common denominator of successive episodic memories. Thus, far from being a medical curiosity. Capgras syndrome may help us to explore the formation of new memories caught in flagrante delicto.
患有卡普格拉综合征的患者会将他们非常熟悉的人，比如他们的父母或兄弟姐妹，视为冒名顶替者。在此，我们描述了该综合征的一个病例（DS），其呈现出几个新特征。DS的情况很不寻常，在于他的妄想具有模态特异性：他声称当看着父母时他们是冒名顶替者，但在通过电话与他们交谈时却不这么认为。与正常人不同，DS对包括他父母在内的熟悉面孔照片的皮肤电导率反应，在幅度上并不比他对不熟悉面孔照片的反应更大。我们认为，在这个患者中，从颞叶的面部处理区域到边缘系统的连接受到了损害，这种缺失可能解释了他为何称父母为冒名顶替者。此外，DS在判断注视方向方面非常差。最后，当向DS展示同一位模特朝着不同方向看的一系列面部照片时，他坚称这些是“看起来彼此很像的不同女性”。在缺乏边缘系统激活的情况下，DS为同一个人创建了单独的记忆“文件”，显然是因为他无法提取并关联连续情景记忆的共同要素。因此，卡普格拉综合征远非一种医学上的奇闻，它可能有助于我们探索正在形成过程中的新记忆的形成。
