Autism and visual agnosia in a child with right occipital lobectomy
Autism and visual agnosia in a child with right occipital lobectomy
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DOI：
10.1136/jnnp.65.4.555
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发表时间：
1998-10-01
影响因子：
11
通讯作者：
Chiron, C
中科院分区：
文献类型：
--
作者：
Jambaqué, I;Mottron, L;Chiron, C
目的：自闭症是一种发育障碍，其神经基础未知。目前自闭症的神经心理学模型认为是视觉知觉表征的异常构建或执行功能的缺陷。这些模型预测自闭症患者的颞枕或额叶区域的大脑病变。本研究旨在研究13岁手术切除右侧颞枕皮质发育不良的13岁女孩的自闭症和视觉失认症症状的存在。方法：神经心理学评估包括韦氏智力量表、单词流利度测试、数字广度测试、Corsi块测试、加利福尼亚语言学习测试、Trail making测试、Benton面部识别测试、Snoodgrass物体识别测试、Rivermead面部学习子测试、以及视觉知觉的发展测试。ADI-R用于显示当前和回顾性自闭症障碍的诊断。神经影像学包括脑MRI、单光子发射计算机断层扫描（SPECT）和PET。结果：脑MRI显示右侧枕部缺损，右侧颞叶皮层异常高信号。PET和SPECT显示左侧额叶代谢低下伴右侧枕叶缺损。神经心理测试显示视觉统觉性失认症和执行功能缺陷。精神病学研究证实了自闭症的诊断。结论：虽然不能排除自闭症和视觉失认是该患者可分离的因素，但这两种缺陷的发现支持了枕颞损伤可能易导致自闭症发展的可能性。
Objectives-Autistic disorder is a developmental handicap with an unknown neurological basis. Current neuropsychological models for autism suggest an abnormal construction of visual perceptual representation or a deficit in executive functions. These models predict cerebral lesions in the temporo-occipital or frontal regions of autistic patients. The present study aimed at studying the presence of symptoms of autism and visual agnosia in a 13 year old girl who had a right temporo-occipital cortical dysplasia that was surgically removed at the age ofMethods-Neuropsychological evaluation included Wechsler and Kaufman intelligence scales, a test of word fluency, digit span, Corsi block, California verbal learning, Trail making, Benton facial recognition, Snoodgrass object recognition tests, Rivermead face learning subtest, and developmental test of visual perception. The ADI-R was used to show current and retrospective diagnosis of autistic disorder. Neuroimagery included brain MRI, single photon emission computed tomography (SPECT), and PET.Results-Brain MRI showed a right occipital defect and an abnormal hyperintensity of the right temporal cortex. PET and SPECT disclosed a left frontal hypometabolism together with the right occipital defect. Neuropsychological testing showed a visual apperceptive agnosia and executive function deficits. Psychiatric study confirmed the diagnosis of autistic disorder.Conclusions-Although the possibility that autism and visual agnosia were dissociable factors in this patient cannot be excluded, the finding of both deficits supports the possibility that occipitotemporal lesions can predispose to the development of autism.