Defective imitation of gestures in patients with damage in the left or right hemispheres
Defective imitation of gestures in patients with damage in the left or right hemispheres
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DOI：
10.1136/jnnp.61.2.176
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发表时间：
1996-08-01
影响因子：
11
通讯作者：
Goldenberg, G
中科院分区：
文献类型：
--
作者：
Goldenberg, G
目的-失用症患者反复表现出对无意义手势的模仿缺陷，并被解释为运动执行缺陷所致。然而，对于右脑损伤的患者是否也会出现模仿障碍，存在争议。其目的是比较缺陷的模仿在患者与左，右脑损伤，并探讨是否有质的差异themes. Methods-模仿进行了检查，在80例患者与左脑损伤（LBD）和失语症，40例患者与右脑损伤（RBD），和60名对照组的三种类型的手势：手的位置，手指的形状，以及需要定义的手部位置以及定义的手指配置的组合手势。结果-无论是否模仿手的位置和手指配置进行了测试，每个对自己或一起，他们表现出不同的易感性RBD和LBD。尽管RBD和LBD患者的手指形状模仿几乎同样受损，但手位置模仿缺陷几乎仅发生在LBD患者中，而对照组和RBD患者的手位置错误比手指形状错误少，LBD患者的情况相反。结论-结果的模式与运动执行缺陷作为LBD患者有缺陷模仿的原因相反，因为很难理解为什么这种缺陷会比不同的手指运动更多地影响到达手位置所需的近端运动。另一种解释是，在LBD患者中，错误是由于对人体的知识有缺陷的中介，而在RED患者中，错误是由于对所演示的手势的错误视觉空间分析。
Objectives-Defective imitation of meaningless gestures has repeatedly been demonstrated in patients with apraxia and has been interpreted as being due to a deficit of motor execution. There is, however, controversy as to whether some impairment of imitation also occurs in patients with right brain damage. The aim was to compare defective imitation in patients with left and right brain damage and to explore whether there are qualitative differences between them.Methods-Imitation was examined in 80 patients with left brain damage (LBD) and aphasia, 40 patients with right brain damage (RBD), and 60 controls for three types of gestures: hand positions, finger configurations, and combined gestures which required a defined hand position as well as a defined configuration of the fingers.Results-Regardless of whether imitation of hand positions and finger configurations were tested each on their own or together, they showed differential susceptibility to RBD and LBD. Whereas imitation of finger configurations was about equally impaired in RBD and LBD, defective imitation of hand positions occurred almost exclusively in patients with LBD, and whereas controls as well as patients with RBD committed less errors with hand positions than with finger configurations, the reverse was the case in patients with LBD.Conclusions-The pattern of results goes against a deficit of motor execution as being the cause of defective imitation in patients with LBD, as it is difficult to see why such a deficit should affect proximal movements necessary for reaching hand positions more than differential finger movements. An alternative explanation would be that in patients with LBD errors are due to defective mediation by knowledge about the human body whereas in patients with RED they stem from faulty visuospatial analysis of the demonstrated gesture.