DECREASE OF CONTRALATERAL NEGLECT BY NECK MUSCLE VIBRATION AND SPATIAL ORIENTATION OF TRUNK MIDLINE
DECREASE OF CONTRALATERAL NEGLECT BY NECK MUSCLE VIBRATION AND SPATIAL ORIENTATION OF TRUNK MIDLINE
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DOI：
10.1093/brain/116.2.383
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发表时间：
1993-04-01
期刊：
影响因子：
14.5
通讯作者：
HARTJE, W
中科院分区：
文献类型：
--
作者：
KARNATH, HO;CHRIST, K;HARTJE, W
三名患有右半球病变和明显左侧忽视但没有视野缺陷的患者被要求检测和识别在左或右半视野中速视镜呈现的刺激。当患者身体处于正常直立位置，躯干、头部和视线直接朝向投影屏幕中间时，可以观察到对侧左侧视野中出现的刺激被忽视，可以通过振动左颈后部肌肉以及将躯干向左转动 15 度来减少。相比之下，通过振动左手肌肉产生的对患者身体左侧的非特异性刺激或通过将头部向左转15度引起的本体感觉信号产生的非特异性刺激没有补偿作用。结果表明，关于左后颈部肌肉的实际延长（通过转动躯干产生）的传入信息与这些肌肉的明显延长（通过其振动产生）一样，导致对侧忽视的缓解。因此，来自颈部肌肉的本体感觉输入，即头对躯干信号，似乎会影响被忽视的患者被忽视的空间部分的延伸。该信号似乎对自我中心参考系的神经生成有很大贡献，该参考系允许确定身体相对于视觉空间的位置。我们假设，通过对侧后颈肌肉的振动来减少忽视是基于矢状中平面在对侧方向上的主观空间定位的转变以及视觉运动协调和空间探索所必需的自我中心坐标系的相应改变。
Three patients with a right hemisphere lesion and marked left-sided neglect without visual field defects were asked to detect and identify stimuli which were tachistoscopically presented in the left or right visual half-field. Neglect of stimuli presented in the contralesional left visual field, which was observed when the patient's body was in a normal upright position with trunk, head and gaze oriented straight ahead to the middle of the projection screen, could be reduced by vibrating the left posterior neck muscles as well as by turning the trunk 15-degrees to the left. In contrast, unspecific stimulation on the left side of the patient's body, produced by vibrating the left hand muscles or the proprioceptive signal induced by turning the head 15-degrees to the left, had no compensatory effects. The results showed that the afferent information about real lengthening of the left posterior neck muscles (produced by turning the trunk) as apparent lengthening of these muscles (produced by their vibration), leads to a remission of contralateral neglect. Thus, the proprioceptive input from the neck muscles, i.e. the head-on-trunk signal, appears to influence the extension of the neglected part of space in patients with neglect. The signal seems to contribute substantially to the neural generation of the egocentric frame of reference that allows the determination of body position with respect to visual space. We hypothesize that the reduction of neglect by vibration of the contralateral posterior neck muscles is based on a shift of the subjective spatial localization of the sagittal midplane in the contralesional direction and a corresponding alteration of the egocentric coordinate system necessary for visuomotor coordination and exploration of space.