The anatomy underlying acute versus chronic spatial neglect: a longitudinal study
The anatomy underlying acute versus chronic spatial neglect: a longitudinal study
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DOI：
10.1093/brain/awq355
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发表时间：
2011-03-01
期刊：
影响因子：
14.5
通讯作者：
Rorden, Chris
中科院分区：
文献类型：
--
作者：
Karnath, Hans-Otto;Rennig, Johannes;Rorden, Chris
我们的目的是研究脑成像在中风的初始阶段如何预测急性/亚急性以及慢性空间忽视。我们提出了第一个体素纵向病变行为映射研究，检查急性/亚急性以及慢性性能在同一个人。急性脑成像（平均伤后6.2天获得）被用来评估忽视症状的初始（平均中风后12.4天）和慢性（平均491天）阶段的中风。慢性忽视被发现在约三分之一的急性忽视的患者。分析表明，上级和颞中回的病变预测急性/亚急性以及慢性忽视。在皮质下水平，基底神经节以及下枕额束/极端胶囊似乎发挥了重要作用，急性/亚急性以及慢性忽视。除此之外，钩束与慢性空间忽视的出现密切相关。我们推断，在中风的初始阶段经历空间忽视但这些皮层和皮层下结构没有损伤的个体可能会恢复，因此具有良好的预后。
Our aim was to examine how brain imaging in the initial phase of a stroke could predict both acute/subacute as well as chronic spatial neglect. We present the first voxel-wise longitudinal lesion-behaviour mapping study, examining acute/subacute as well as chronic performance in the same individuals. Acute brain imaging (acquired on average 6.2 days post-injury) was used to evaluate neglect symptoms at the initial (mean 12.4 days post-stroke) and the chronic (mean 491 days) phase of the stroke. Chronic neglect was found in about one-third of the patients with acute neglect. Analysis suggests that lesion of the superior and middle temporal gyri predict both acute/subacute as well as chronic neglect. At the subcortical level, the basal ganglia as well as the inferior occipitofrontal fasciculus/extreme capsule appear to play a significant role for both acute/subacute as well as chronic neglect. Beyond, the uncinate fasciculus was critically related to the emergence of chronic spatial neglect. We infer that individuals who experience spatial neglect in the initial phase of the stroke yet do not have injury to these cortical and subcortical structures are likely to recover, and thus have a favourable prognosis.