Perception of active head rotation in patients with severe left unilateral spatial neglect.
Perception of active head rotation in patients with severe left unilateral spatial neglect.
复制标题
严重左单侧空间忽视患者主动头部旋转的感知。
DOI：
10.1016/j.jocn.2017.01.003
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发表时间：
2017
影响因子：
2
通讯作者：
Kaba H.
中科院分区：
文献类型：
--
作者：
Kaibe S;Okita M;Kaba H.
单侧空间忽视是一种常见的神经系统综合征，主要是右半球损伤，其特征是无法感知和报告空间对侧的刺激。为了验证参照转移假说，即右脑损伤患者的对位性空间忽视归因于自我中心参照系的向右偏移，我们测量了控制组和左侧忽视患者在有和没有视觉反馈的两种情况下，在三个位置（右、左、前）的口头指示下，主动把头转向左边的最终角度位置。当被忽视的病人被要求“直视前方”时，他们在睁开眼睛的情况下向右偏离了大约30°。然而，在闭眼条件下，向右偏移明显减少。在不考虑视觉反馈的情况下，当言语指令来自受试者的左侧或前方时，对照组和被忽视患者在主动头部旋转的最终角度位置上没有显著差异；然而，当从右侧给予口头指示时，被忽视患者的最终角度位置明显小于对照组。这些结果支持了这样一种观点，即在积极的头部旋转过程中，颈前庭刺激可以恢复空间映射和感觉-运动相关性，从而在不影响自我中心参照位置的情况下改善忽视；然而，一旦左侧忽视患者对来自右侧的言语指令做出反应，他们就无法将注意力从大脑半球中分离出来，并且头部旋转的表现受到干扰。
Unilateral spatial neglect is a common neurological syndrome following predominantly right hemisphere damage, and is characterized by a failure to perceive and report stimuli in the contralesional side of space. To test the reference shift hypothesis that contralesional spatial neglect in right-brain-damaged patients is attributed to a rightward deviation of the egocentric reference frame, we measured the final angular position to which controls and left-side neglect patients actively turned their head toward the left in response to a verbal instruction given from each of three locations—right, left, and front—in two conditions, with and without visual feedback. When neglect patients were asked to “look straight ahead”, they deviated about 30° toward the right in the eyes-open condition. However, the rightward deviation was markedly reduced in the eyes-closed condition. Regardless of visual feedback, there was no significant difference between controls and neglect patients in the final angular position of active head rotation when the verbal instruction came from the subject’s left or front side; however, the final angular position was significantly smaller in the neglect patients than in the controls when the verbal instruction was given from the right. These results support the contention that cervico-vestibular stimulation during active head rotation restores spatial remapping and sensori-motor correlations and so improves neglect without affecting the position of the egocentric reference; however, once left-side neglect patients respond to verbal instruction from the right side, they are unable to disengage attention from the hemispace, and the performance of head rotation is disturbed.