VENTROLATERAL AND DORSOMEDIAL SOMATOSENSORY ASSOCIATION CORTEX DAMAGE PRODUCES DISTINCT SOMATESTHETIC SYNDROMES IN HUMANS
VENTROLATERAL AND DORSOMEDIAL SOMATOSENSORY ASSOCIATION CORTEX DAMAGE PRODUCES DISTINCT SOMATESTHETIC SYNDROMES IN HUMANS
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DOI：
10.1212/wnl.43.4.762
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发表时间：
1993-04-01
期刊：
影响因子：
9.9
通讯作者：
CASELLI, RJ
中科院分区：
文献类型：
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作者：
CASELLI, RJ
有五个体感皮质具有不同的躯体视觉表征、细胞结构和连接：初级体感皮质(SI)、腹外侧联皮质(SII、SIII和SIV)和背内侧联结皮质(辅助感觉区)。对5例腹外侧局灶性和6例背内侧局灶性躯体感觉联合皮质(SAs)和8例偏瘫患者和14例神经正常对照患者进行了详细的躯体感觉测试，包括基本、中等和复杂(触觉物体识别)躯体感觉功能。当损伤范围广泛且累及前皮质和后皮质时，背内侧病变可导致严重的躯体感觉加工障碍和严重的失用。相比之下，腹外侧损伤导致触觉失认。在慢性情况下，背内侧损伤后的感觉运动功能有显著改善。然而，腹外侧损伤后的触觉失认症在发病后数年内很容易被检测到。腹外侧囊和背内侧囊之间的功能差异可能反映了双重躯体感觉系统的平行处理。
Five somatosensory cortices have distinctive somatotopic representations, cytoarchitecture, and connectivity: primary somatosensory cortex (SI), ventrolateral association cortices (SII, SIII, and SIV), and dorsomedial association cortex (supplementary sensory area). Patients with focal lesions of ventrolateral (n = 5) and dorsomedial (n = 6) somatosensory association cortices (SACs) and hemiparetic (n = 8) and neurologically normal control patients (n = 14) underwent detailed somesthetic testing that encompassed basic, intermediate, and complex (tactile object recognition) somesthetic functions. Dorsomedial lesions acutely caused severe disruption of somesthetic processing and severe apraxia when the area of damage was extensive and involved anterior and posterior cortices. In contrast, ventrolateral lesions caused tactile agnosia. Chronically, sensorimotor function following dorsomedial damage improved considerably. Tactile agnosia following ventrolateral damage, however, was readily detectable for years following onset. Functional differences between ventrolateral and dorsomedial SACs may reflect parallel processing in dual somatosensory systems.