Damage to White Matter Fiber Tracts in Acute Spatial Neglect
Damage to White Matter Fiber Tracts in Acute Spatial Neglect
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DOI：
10.1093/cercor/bhn250
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发表时间：
2009-10-01
期刊：
影响因子：
3.7
通讯作者：
Ticini, Luca F.
中科院分区：
文献类型：
--
作者：
Karnath, Hans-Otto;Rorden, Chris;Ticini, Luca F.
先前的统计体素损害行为图(VLBM)研究表明，空间忽视与皮质和皮质下灰质损伤有关。然而，也有研究表明，这种疾病可能是由于脑白质损伤引起的。我们的目的是调查140名中风患者的脑白质连通性。我们结合了VLBM方法和Julich概率细胞构筑图谱提供的人类白质纤维束的组织学图谱。我们发现，右侧坐骨神经周围白质连接受损--上纵束、枕额下束和枕额上束--是空间忽视患者的典型表现。然而，分析也显示，病变区域的最大部分，即891%至96.6%，影响到除了坐骨神经周围白质纤维束以外的脑结构。主要包括灰质结构，如上颞叶、下顶叶、下额叶和岛叶皮质，以及皮质下的壳核和尾状核。因此，灰质结构的损伤似乎是空间忽视的一个强有力的预测因素。
Previous statistical voxelwise lesion-behavior mapping (VLBM) studies have demonstrated that spatial neglect is associated with cortical and subcortical gray matter damage. However, it has also been suggested that the disorder may result from white matter injury. Our aim was to investigate the white matter connectivity in a large sample of 140 stroke patients. We combined a VLBM approach with the histological maps of the human white matter fiber tracts provided by the Julich probabilistic cytoarchitectonic atlas. We found that damage of right perisylvian white matter connections-the superior longitudinal fasciculus, the inferior occipitofrontal fasciculus, and the superior occipitofrontal fasciculus-is a typical finding in patients with spatial neglect. However, the analysis also revealed that the largest portion of the lesion area, namely between 89.1% and 96.6%, affected brain structures other than the perisylvian white matter fiber tracts. Predominantly, these included gray matter structures such as the superior temporal, inferior parietal, inferior frontal, and insular cortices, as well as subcortically the putamen and the caudate nucleus. Damage of gray matter structures thus appears to be a strong predictor of spatial neglect.