Dissociable spatial and non-spatial attentional deficits after circumscribed thalamic stroke
Dissociable spatial and non-spatial attentional deficits after circumscribed thalamic stroke
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DOI：
10.1016/j.cortex.2014.12.005
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发表时间：
2015-03-01
期刊：
影响因子：
3.6
通讯作者：
Brandt, Stephan A.
中科院分区：
文献类型：
--
作者：
Kraft, Antje;Irlbacher, Kerstin;Brandt, Stephan A.
丘脑核团在多个皮层下区域和大脑皮层之间充当感觉、运动和认知中继。它们在执行功能、记忆和注意力等认知功能中起着至关重要的作用。在丘脑卒中后的急性期，注意力缺陷是常见的。丘脑特定核团或血管亚区与注意力亚功能的精确功能相关性仍不清楚。视觉注意理论（TVA）允许测量四个独立的注意参数（视觉短时记忆存储容量（VSTM）、视知觉处理速度、选择控制和空间加权）。我们在16名患者（平均年龄41.2 ± 11.0 SD，6名女性）的标准立体定向空间中将基于TVA的参数评估与病变症状标测相结合，这些患者的丘脑病灶位于丘脑的内侧（N = 9）、外侧（N = 5）、前部（N = 1）或后部（N = 1）血管区域。与年龄匹配的对照组52名受试者（平均年龄40.1 ± 6.4，35名女性）相比，丘脑病变患者的视觉处理速度和VSTM轻度受损。外侧丘脑病变的患者显示处理速度不足，而所有其他TVA参数均在正常范围内。内侧丘脑病变可能与同病灶或对病灶视野中靶点的空间偏倚和消光相关。一个丘脑枕损害的后部病例重复了Habekost和Rostrup（2006）的发现，证明了同病灶场的空间偏倚，正如视觉注意神经理论（NTVA）所建议的那样（Bundesen，Habekost，& Kyllingsbaek，2011）。一个前内侧丘脑病变的情况下，表现出减少选择性注意控制。我们的结论是，在不同的血管亚区域的丘脑病变与不同的注意力综合征（内侧=空间偏差，外侧=处理速度）。(C)2015爱思唯尔有限公司版权所有。
Thalamic nuclei act as sensory, motor and cognitive relays between multiple subcortical areas and the cerebral cortex. They play a crucial role in cognitive functions such as executive functioning, memory and attention. In the acute period after thalamic stroke attentional deficits are common. The precise functional relevance of specific nuclei or vascular sub regions of the thalamus for attentional sub functions is still unclear. The theory of visual attention (TVA) allows the measurement of four independent attentional parameters (visual short term memory storage capacity (VSTM), visual perceptual processing speed, selective control and spatial weighting). We combined parameter-based assessment based on TVA with lesion symptom mapping in standard stereotactic space in sixteen patients (mean age 41.2 +/- 11.0 SD, 6 females), with focal thalamic lesions in the medial (N = 9), lateral (N = 5), anterior (N = 1) or posterior (N = 1) vascular territories of the thalamus. Compared with an age-matched control group of 52 subjects (mean age 40.1 +/- 6.4, 35 females), the patients with thalamic lesions were, on the group level, mildly impaired in visual processing speed and VSTM. Patients with lateral thalamic lesions showed a deficit in processing speed while all other TVA parameters were within the normal range. Medial thalamic lesions can be associated with a spatial bias and extinction of targets either in the ipsilesional or the contralesional field. A posterior case with a thalamic lesion of the pulvinar replicated a finding of Habekost and Rostrup (2006), demonstrating a spatial bias to the ipsilesional field, as suggested by the neural theory of visual attention (NTVA) (Bundesen, Habekost, & Kyllingsbaek, 2011). A case with an anterior-medial thalamic lesion showed reduced selective attentional control. We conclude that lesions in distinct vascular sub regions of the thalamus are associated with distinct attentional syndromes (medial = spatial bias, lateral = processing speed). (C) 2015 Elsevier Ltd. All rights reserved.