AGRAPHESTHESIA - A DISORDER OF DIRECTIONAL CUTANEOUS KINESTHESIA OR A DISORIENTATION IN CUTANEOUS SPACE
AGRAPHESTHESIA - A DISORDER OF DIRECTIONAL CUTANEOUS KINESTHESIA OR A DISORIENTATION IN CUTANEOUS SPACE
复制标题
DOI：
10.1016/0022-510x(82)90249-0
复制
发表时间：
1982-01-01
影响因子：
4.4
通讯作者：
COHEN, J
中科院分区：
文献类型：
--
作者：
BENDER, MB;STACY, C;COHEN, J
除了辨别感觉的标准测试外，还对一大批神经科患者和正常受试者进行了图形感觉和定向皮肤运动感觉(DCK)测试。图形感觉和DCK均有缺陷，神经系统各节段均有损害。图形感觉受到的影响比DCK更多、更严重。当这些功能受损时，总是与其他感觉缺陷(定向关节运动感觉、两点辨别等)相关。在不同的组合中。DCK可能是图形知觉的基础。最近的实验研究为DCK和图形感觉提供了解剖学和生理学基础。这些研究还推翻了人们普遍认为的通过脊髓传递歧视感觉的观点。回顾了关于感觉及其调节的思想的历史；DCK本身值得被称为后柱功能。图形感觉和DCK被认为是在皮肤感觉空间暗示定向的运动感觉功能。这些与立体识别和盲文阅读相比，这是复杂的派生功能，也依赖于运动，但指向外部触觉空间的识别。图形感觉和DCK都应该被认为是躯体感觉的不同形式，对临床感觉检查是有价值的辅助手段。
Tests for graphesthesia and for directional cutaneous kinesthesia (DCK) were performed on a large series of neurological patients and normal subjects, in addition to the standard tests for discriminative sensation. Defects in graphesthesia and DCK were found with lesions at all levels of the nervous system. Graphesthesia was more often and more severely affected than DCK. These functions when impaired were always associated with other sensory defects (directional joint kinesthesia, 2-point discrimination, etc.) in different combinations. It appears DCK is probably the basis for graphesthesia. Recent experimental studies have provided an anatomic and physiologic basis for DCK and for graphesthesia. These studies have also discredited widely held beliefs on the transmission of discriminative sensation through the spinal cord. The history of ideas about sensation and its mediation are reviewed; DCK alone deserves to be called a posterior column function. Graphesthesia and DCK are discussed as kinesthetic functions implying orientation in cutaneous sensory space. These are compared to stereognosis and braille reading, which are complex derived functions depending also on motion but directed towards recognition in external haptic space. Graphesthesia and DCK should both be considered as distinct forms of somatic sensibility which are valuable adjuncts to the clinical sensory examination.