Selective impairment of hand mental rotation in patients with focal hand dystonia
Selective impairment of hand mental rotation in patients with focal hand dystonia
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DOI：
10.1093/brain/awh630
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发表时间：
2006-01-01
期刊：
影响因子：
14.5
通讯作者：
Aglioti, SM
中科院分区：
文献类型：
--
作者：
Fiorio, M;Tinazzi, M;Aglioti, SM
身体部位的心理旋转决定了参与运动计划和执行的皮层和皮层下系统的激活，例如运动区和运动前区以及基底神经节。这些结构在几种运动障碍中严重受损，包括肌张力障碍。书写痉挛是局灶性手肌张力障碍最常见的形式。本研究调查是否受作家的抽筋目前的困难，涉及身体部位的心理旋转的任务，以及是否有任何损害是特定的受影响的手或广义的其他身体部位的患者。为此，我们测试了15例右书写痉挛患者（年龄21-68岁，8名女性）和15名健康对照组（10名女性，年龄和教育程度匹配）。刺激包括在计算机显示器上呈现的手和脚的现实照片，相对于直立的规范方向在不同的方向。在每个试验中，受试者通过口头报告所呈现的身体部位是左边还是右边来做出偏侧性判断。本研究的两个主要结果是：第一，书写痉挛患者在心理旋转手时比对照组慢[F（1，28）= 5.4; P = 0.028]，而不是脚，其次，对不同方向刺激的反应时间的模式表明，控制组和患者的心理运动想象反映了在实际执行过程中发挥作用的过程和机制的类型。同样的动作。特别是，旋转右侧刺激120度和左侧刺激240度的难度增加表明，身体部位的心理旋转反映了真实的手部运动的解剖学约束。总之，书写痉挛的患者出现了手部特有的心理旋转缺陷。重要的是，赤字是目前在心理旋转的右手（受影响）和左手（未受影响），从而表明所观察到的变化可能是独立的，甚至存在之前的明显表现的肌张力障碍。
Mental rotation of body parts determines activation of cortical and subcortical systems involved in motor planning and execution, such as motor and premotor areas and basal ganglia. These structures are severely impaired in several movement disorders, including dystonia. Writer's cramp is the most common form of focal hand dystonia. This study investigates whether patients affected by writer's cramp present with difficulties in tasks involving mental rotation of body parts and whether any impairments are specific to the affected hand or generalized to other body parts. For this purpose we tested 15 patients with right writer's cramp (aged 21-68 years, 8 women) and 15 healthy control subjects (10 women, age and education matched). Stimuli consisted of realistic photographs of hands and feet presented on a computer monitor in different orientations with respect to the upright canonical orientation. In each trial, subjects gave a laterality judgement by reporting verbally whether the presented body part was left or right. Two main results of the study are, firstly, writer's cramp patients are slower than controls in mentally rotating hands [F (1,28) = 5.4; P = 0.028] but not feet, and secondly, the pattern of response times to stimuli at various orientations suggests that the mental motor imagery of controls and patients reflects the type of processes and mechanisms called into play during actual execution of the same movements. In particular, increased difficulty in rotating right-sided stimuli at 120 degrees and left-sided stimuli at 240 degrees would suggest that mental rotation of body parts reflects the anatomical constraints of real hand movements. In conclusion, patients with writer's cramp presented mental rotation deficits specific to the hand. Importantly, deficits were present during mental rotation of both the right (affected) and the left (unaffected) hand, thus suggesting that the observed alterations may be independent and even exist prior to overt manifestations of dystonia.