SENSORY APROSODIA - A CLINICAL CLUE TO LESIONS OF THE INFERIOR DIVISION OF THE RIGHT MIDDLE CEREBRAL-ARTERY
SENSORY APROSODIA - A CLINICAL CLUE TO LESIONS OF THE INFERIOR DIVISION OF THE RIGHT MIDDLE CEREBRAL-ARTERY
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DOI：
10.1212/wnl.43.3_part_1.567
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发表时间：
1993-03-01
期刊：
影响因子：
9.9
通讯作者：
DARBY, DG
中科院分区：
文献类型：
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作者：
DARBY, DG
右侧大脑中动脉（MCA）下分支区域的孤立性梗死常伴有细微的临床特征。感觉性韵律失准症是一种情感性言语障碍（情感韵律），具有受损的韵律情感理解和重复（但相对较少的表达）以及情感手势识别的额外损伤，已被认为是此类病变的潜在临床有用标志物。我们在一项前瞻性系列研究中检验了这一假设，研究对象是最近CT显示的原发性单侧脑梗死的母语为英语者。在42例涉及MCA区域的梗死患者中，有4例右侧MCA下分区梗死（右侧27例，左侧16例）。4例患者出现急性感觉性失语症：2例右侧MCA下分区病变，1例更广泛的右侧MCA病变（神经系统体征与右侧MCA下分区病变一致），1例左侧MCA梗死。在梗死后约20天，有3例患者感觉性失语，其中2例为右MCA下分区病变，另1例为右MCA上级分区梗死。没有健康对照组或腔隙性脑梗死患者显示此特征。我们的结论是：感觉性失语（1）可以用标准化的客观方法识别，（2）是右侧MCA区域下分区梗死的急性标志物，（3）梗死后数周特异性较低，（4）与腔隙性梗死无关。
Isolated infarction in the territory of the inferior division of the right middle cerebral artery (MCA) is often associated with subtle clinical features. Sensory aprosodia, a disorder of emotional speech (affective prosody) with impaired prosodo-affective comprehension and repetition (but relatively spared expression) and added impairment of identification of emotional gesturing, has been advanced as a potential clinically useful marker for such lesions. We examine this hypothesis in a prospective serial study of native Anglophones with a recent initial unilateral cerebral infarction demonstrated on CT. There were four patients with inferior divisional infarctions of the right MCA among 42 with infarctions involving the MCA territory (27 right, 16 left). Sensory aprosodia was present acutely in four patients: two inferior divisional right MCA lesions, one more extensive right MCA lesion (with neurologic signs consistent with predominant inferior division of right MCA impairment), and one left MCA infarction. At approximately 20 days postinfarction, there were three patients with sensory aprosodia, including two with inferior divisional right MCA lesions and another with superior divisional right MCA infarction. No healthy controls or lacunar infarction patients showed this profile. We conclude that sensory aprosodia (1) is identifiable with standardized, objective methodology, (2) is an acute marker of inferior divisional infarction in the right MCA territory, (3) is less specific several weeks after infarction, and (4) is not associated with lacunar infarction.