Leibovitch F S, Black S E, Caldwell C B, Ebert P L, Ehrlich L E, Szalai J P
Department of Medicine, Research Program in Aging, Sunnybrook Health Science Centre, University of Toronto, Ontario, Canada.
Neurology. 1998 Apr;50(4):901-8. doi: 10.1212/wnl.50.4.901.
Structural and functional lesion localization in patients with hemispatial neglect.
Location and severity of brain damage on CT and SPECT correlated with neglect performance as assessed with a battery of drawings, line bisection, and line and shape cancellation subtests.
Participants included 120 consecutive stroke patients with a single right-hemisphere-damaged lesion on CT who were admitted to the Acute Stroke Care Unit at Sunnybrook Health Science Centre. Of these, 88 also had a SPECT.
On CT, 82 patients with neglect (compared with 38 without neglect) had more extensive damage in the parietal and sensorimotor cortex and white matter fiber bundles, including the posterior-superior longitudinal and inferior-frontal fasciculi (p < 0.05). Parietal and anterior cingulate damage best predicted neglect score using the CT data (p < 0.05), and regional blood flow in the parietal cortex best predicted neglect score using the SPECT data (p < 0.05) after controlling for the influence of age and lesion size on multiple linear regression.
Damage in the parietal and anterior cingulate cortex and posterior white matter fiber bundles correlated with hemispatial neglect. Combining structural- and functional-imaging techniques with neurobehavioral analysis can elucidate brain-behavior relationships.
对偏侧空间忽视患者进行结构和功能损伤定位。
通过一系列绘图、直线二等分以及直线和形状删除子测试评估，将CT和SPECT上脑损伤的位置和严重程度与忽视表现相关联。
参与者包括120例连续入住桑尼布鲁克健康科学中心急性卒中护理单元的卒中患者，这些患者在CT上有单一的右半球损伤病灶。其中88例还进行了SPECT检查。
在CT上，82例有忽视症状的患者（相比之下38例无忽视症状的患者）在顶叶、感觉运动皮层和白质纤维束有更广泛的损伤，包括后上纵束和额下束（p < 0.05）。使用CT数据时，顶叶和前扣带回损伤最能预测忽视评分（p < 0.05），在多元线性回归中控制年龄和病灶大小的影响后，使用SPECT数据时，顶叶皮层的局部脑血流最能预测忽视评分（p < 0.05）。
顶叶、前扣带回皮层和后白质纤维束的损伤与偏侧空间忽视相关。将结构和功能成像技术与神经行为分析相结合可以阐明脑与行为的关系。
