SUBJECTIVE BODY ORIENTATION IN NEGLECT AND THE INTERACTIVE CONTRIBUTION OF NECK MUSCLE PROPRIOCEPTION AND VESTIBULAR STIMULATION
SUBJECTIVE BODY ORIENTATION IN NEGLECT AND THE INTERACTIVE CONTRIBUTION OF NECK MUSCLE PROPRIOCEPTION AND VESTIBULAR STIMULATION
复制标题
DOI：
10.1093/brain/117.5.1001
复制
发表时间：
1994-10-01
期刊：
影响因子：
14.5
通讯作者：
KARNATH, HO
中科院分区：
文献类型：
--
作者：
KARNATH, HO
三名患有右侧、主要顶叶病变和明显左侧忽视且无视野缺陷的患者被要求将激光点指向他们认为正好位于其身体方向“正前方”的位置。而在光明和黑暗中，对照组的主观身体方向接近客观身体位置，三名忽视患者将身体的矢状中平面定位于与客观方向右侧15度相似的位置。在垂直平面上，被忽视的患者和对照组之间没有发现“直线前进”的相关差异。被忽视的患者矢状中平面向右的水平位移可以通过颈部肌肉振动或左侧的热量前庭刺激来补偿。当前庭刺激与颈部肌肉振动相结合时，水平偏差通过添加或抵消仅在对照组和被忽视的患者中单独应用两种类型的刺激时观察到的效果而线性组合。而且;数据分析显示，被忽视的患者的主观身体定向的同侧移位并不是由于初级知觉受到干扰或来自周围的前庭或本体感觉输入的传输受到干扰造成的。目前的结果支持这样的假设，即导致脑损伤患者被忽视的重要方面是那些皮质结构的紊乱，这些皮质结构对于将来自周围感觉器官（这里是视网膜、颈部肌梭和铜）的感觉输入坐标转变为以自我为中心、以身体为中心的参考坐标系至关重要。在被忽视的患者中，坐标变换似乎与空间参考系向同侧的系统误差和偏差一起工作，导致身体方向的主观定位的相应位移。可以进一步得出结论，颈部肌肉本体感觉和前庭刺激直接相互作用，有助于受试者对空间的心理表征。数据表明，来自这些不同输入通道的传入信息同时用于计算以自我为中心、以身体为中心的坐标，从而使我们能够确定我们的身体在空间中的位置。
Three patients with a right, predominantly parietal lesion and marked left-sided neglect without visual field defects were asked to direct a laser point to the position which they felt to lie exactly 'straight ahead' of their bodies orientation Whereas in both light and darkness, the subjective body orientation was close to the objective body position in the control groups, the three neglect patients localized the body's sagittal midplane similar to 15 degrees to the right of the objective orientation. No relevant differences of 'straight ahead' were found between the neglect patients and controls in the vertical plane. The neglect patients' horizontal displacement of sagittal midplane to the right could be compensated for either by neck muscle vibration or by caloric vestibular stimulation on the left side. When vestibular stimulation was combined with neck muscle vibration, the horizontal deviation linearly combined by adding or neutralizing the effects observed when both types of stimulation were applied exclusively in the control groups as well as in the neglect patients. Moreover; data analysis revealed that the neglect patients' ipsilesionally displaced subjective body orientation does not result fi om a disturbed primary perception or disturbed transmission of the vestibular or proprioceptive input from the periphery. The present results support the hypothesis that the essential aspect leading to neglect in brain-damaged patients is a disturbance of those cortical structures that are crucial for transforming the sensory input coordinates from the peripheral sensory organs-here the retina, neck muscle spindles and cuprlae-into an egocentric, body-centred coordinate frame of reference. In neglect patients the coordinate transformation seems to work with a systematic error and deviation of the spatial reference frame to the ipsilesional side leading to a corresponding displacement of subjective localization of body orientation. It can be concluded further that neck muscle proprioception and vestibular stimulation directly interact in contributing to the subject's mental representation of space. The data suggest that the afferent information from these different input channels is used simultaneously for computing egocentric, body-centred coordinates that allow us to determine our body position in space.