The Effects of Deep-Reaching Lesions in the Cortical Face Area on Phonation a Combined Case Report and Experimental Monkey Study
The Effects of Deep-Reaching Lesions in the Cortical Face Area on Phonation a Combined Case Report and Experimental Monkey Study
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面部皮质区域深层病变对发声的影响结合病例报告和实验猴研究
DOI：
10.1016/s0010-9452(82)80024-5
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发表时间：
1982
期刊：
影响因子：
3.6
通讯作者：
D. V. Cramon
中科院分区：
文献类型：
--
作者：
U. Jürgens;A. Kirzinger;D. V. Cramon
本研究比较了患者的发声能力与deepreaching左侧病变的皮质面部区域与两只松鼠猴，其中患者的病变已被复制双边。病变涉及Broca区，下前和后中央皮层，rolandic岛盖，下顶叶皮层，屏状核，部分壳核和白色物质下方的下额顶叶和岛叶cort.While松鼠猴没有表现出任何发音缺陷，病人成为失语症超过10周后的侮辱。在此期间之后，发声稳定地恢复到稍微有呼吸但单调的声音，歌唱能力有所降低。在无声期，有一个双侧声带完全麻痹。患者和猴均表现出下面部和舌肌麻痹，患者伴有构音障碍和颊舌失用症，猴伴有进食困难。人类失音症和完整的猴子发声之间的差异，一方面，完整的发声和有缺陷的ororofacial行为在猴子，另一方面，解释了解剖学的事实，有一个直接的皮质投射到疑核在人，但不是在猴子，而面部和舌下神经核接受直接的皮质投射在人和猴子。猴喉运动神经元缺乏直接的皮质控制，这是由于对精细声带运动缺乏意志控制所造成的。
The present study compares the phonatory ability of a patient with a deepreaching left-sided lesion in the region of the cortical face area with that of two squirrel monkeys in which the patient's lesion has been reduplicated bilaterally. The lesion involved Broca's area, the inferior pre- and postcentral cortex, rolandic operculum, inferior parietal cortex insula, claustrum, parts of the putamen and white matter underlying the inferior frontoparietal and insular cortex.While the squirrel monkey did not show any phonatory deficits, the patient became aphonic for more than 10 weeks following the insult. After that period, phonation recovered steadily to a slightly breathy but monotonous voice with a somewhat reduced singing capacity. During the aphonic period, there was a bilateral complete paresis of the vocal folds. Both, patient and monkey, showed a paresis of the lower facial and tongue muscles which was accompanied by dysarthria and buccolingual apraxia in the patient and feeding difficulties in the monkey. The discrepancy between human aphonia and intact monkey phonation, on the one hand, and intact phonation and defective orofacial behaviour in the monkey, on the other, is explained by the anatomical fact that there is a direct cortical projection to the nucleus ambiguus in man but not in monkey, whereas the facial and hypoglossal nuclei receive direct cortical projections in man and monkey. The lack of direct cortical control of the laryngeal motoneurones in the monkey is paralleled by a lack of volitional control of fine vocal fold movements.