Awareness of the functioning of one's own limbs mediated by the insular cortex?
Awareness of the functioning of one's own limbs mediated by the insular cortex?
复制标题
DOI：
10.1523/jneurosci.1590-05.2005
复制
发表时间：
2005-08-03
影响因子：
5.3
通讯作者：
Nägele, T
中科院分区：
文献类型：
--
作者：
Karnath, HO;Baier, B;Nägele, T
通常，我们知道我们的手臂和腿的当前功能。然而，这种不言而喻的状态可能会在脑损伤后发生巨大变化。一些患有“病感失认症”的患者通常确信他们的肢体功能正常，尽管他们在中风后有明显的运动缺陷。这样的病人可能会觉得自己的瘫痪肢体很奇怪，或者不属于他们，甚至可能把所有权归于另一个人，并试图把他们瘫痪的肢体从床上推下来。这些奇怪的信念被归因于右脑某处的干扰。在这里，我们使用27例卒中患者的病变标测来显示，偏瘫/轻偏瘫的病感失认患者的右后额叶通常受损，但在没有病感失认的偏瘫/轻偏瘫患者中，右后额叶受损明显较少。后岛叶皮质的功能一直有争议的讨论。最近的神经影像学结果显示，健康受试者的感觉与不参与运动的具体参与这一领域。我们的发现与这一观察相一致，并表明岛叶皮层是自我意识和一个人对身体部位功能的信念不可或缺的。
Normally, we are aware of the current functions of our arms and legs. However, this self-evident status may change dramatically after brain damage. Some patients with "anosognosia" typically are convinced that their limbs function normally, although they have obvious motor defects after stroke. Such patients may experience their own paretic limbs as strange or as not belonging to them and may even attribute ownership to another person and try to push their paralyzed limb out of bed. These odd beliefs have been attributed to disturbances somewhere in the right hemisphere. Here, we use lesion mapping in 27 stroke patients to show that the right posterior insula is commonly damaged in patients with anosognosia for hemiplegia/hemiparesis but is significantly less involved in hemiplegic/hemiparetic patients without anosognosia. The function of the posterior insular cortex has been controversially discussed. Recent neuroimaging results in healthy subjects revealed specific involvement of this area in the subject's feeling of being versus not being involved in a movement. Our finding corresponds with this observation and suggests that the insular cortex is integral to self-awareness and to one's beliefs about the functioning of body parts.