Reperfusion of specific cortical areas is associated with improvement in distinct forms of hemispatial neglect
Reperfusion of specific cortical areas is associated with improvement in distinct forms of hemispatial neglect
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DOI：
10.1016/j.cortex.2011.01.003
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发表时间：
2012-05-01
期刊：
影响因子：
3.6
通讯作者：
Hillis, Argye E.
中科院分区：
文献类型：
--
作者：
Khurshid, Shaan;Trupe, Lydia A.;Hillis, Argye E.
目的：检验以下假设：恢复急性中风中特定右皮质区域的血流可改善不同形式的半侧空间忽视，通过参考系区分：以观察者为中心与以刺激为中心的忽视。方法：在第 1 天和第 3-5 天，通过一系列忽视测试以及弥散和灌注加权 MR 成像对 25 名急性右中风患者进行评估。多元线性回归分析揭示了布罗德曼区域（BA），其中再灌注可预测每种类型忽视的评分改善程度，与其他区域的再灌注、梗塞或灌注不足体积的总变化以及年龄无关。结果：背侧额顶叶皮层（包括 BA 40、46 和 4）的再灌注独立预测以观看者为中心的忽视的改善，例如检测左侧直线取消和场景复制的刺激（r = .951；p < .0001）。更腹侧的颞枕皮层（包括右侧 BA 37、38、21 和 18）的再灌注独立地有助于改善以刺激为中心的忽视，例如检测圆圈中的左侧间隙（r = .926；p < .0001）。右侧中梭状回（颞枕皮质）的再灌注、总缺血体积的变化、低灌注体积的变化以及年龄预测的阅读改善程度（“忽略阅读障碍”错误的减少；r = .915；p < .0001）。结果表明，对特定皮质区域进行再灌注可以改善不同类型的忽视。 (C) 2011 爱思唯尔有限公司。版权所有。
Objective: To test the hypothesis that restoring blood flow to specific right cortical regions in acute stroke results in improvement in distinct forms of hemispatial neglect distinguished by reference frame: viewer-centered versus stimulus-centered neglect. Methods: Twenty five patients with acute right stroke were evaluated at Day 1 and Day 3-5 with a battery of neglect tests and Diffusion- and Perfusion-Weighted MR Imaging. Multivariate linear regression analysis revealed Brodmann areas (BAs) where reperfusion predicted degree of improvement in scores on each type of neglect, independently of reperfusion of other areas, total change in the volume of infarct or hypoperfusion, and age. Results: Reperfusion of dorsal frontoparietal cortex (including BAs 40, 46, and 4) independently predicted improvement in viewer-centered neglect, such as detecting stimuli on left in line cancellation and scene copying (r = .951; p < .0001). Reperfusion of a more ventral temporooccipital cortex, including right BAs 37, 38, 21 and 18, independently contributed to improvement in stimulus-centered neglect, such as detecting left gaps in circles (r = .926; p < .0001). Reperfusion of right midfusiform gyrus (temporal occipital cortex), change in total volume of ischemia, change in volume of hypoperfusion and age predicted degree of improvement in reading (reduction in "neglect dyslexic" errors; r = .915; p < .0001). Results demonstrate that reperfusing specific cortical regions yields improvement in different types of neglect. (C) 2011 Elsevier Srl. All rights reserved.