Hemispatial neglect - Subtypes, neuroanatomy, and disability
Hemispatial neglect - Subtypes, neuroanatomy, and disability
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DOI：
10.1212/01.wnl.0000113730.73031.f4
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发表时间：
2004-03-09
期刊：
影响因子：
9.9
通讯作者：
Coslett, HB
中科院分区：
文献类型：
--
作者：
Buxbaum, LJ;Ferraro, MK;Coslett, HB
目的：评估康复环境中右半球卒中患者运动、知觉、个人周围和个人忽视亚型发生的相对频率，忽视与其他相关缺陷（例如，非偏侧注意力缺陷、失认症）的关联，以及忽视的神经解剖学基础。方法：作者对 166 名右半球中风住院和门诊康复患者进行了评估，评估了忽视和忽视亚型、注意力、运动和感觉功能、功能残疾和家庭负担。还进行了详细的病变分析。结果：48% 的右半球中风患者存在被忽视的情况。与没有被忽视的患者相比，被忽视的患者有更多的运动障碍、感觉功能障碍、视觉消退、基本（非偏侧）注意力缺陷和失认症。 1% 发生个人忽视，27% 发生个人周围忽视，17% 发生运动忽视，21% 发生知觉忽视。忽视严重程度对功能独立测量和家庭负担问卷得分的预测比病变区域的数量更准确。结论：忽视综合征本身，而不是总体卒中严重程度，预示着右半球卒中的不良预后。评估忽视亚型的任务之间的分离支持这些亚型的存在。最后，忽视是由分布式系统内各个位点的病变引起的，该系统介导注意力和空间运动表现的多个方面。
Objective: To assess the relative frequency of occurrence of motor, perceptual, peripersonal, and personal neglect subtypes, the association of neglect and other related deficits ( e. g., deficient nonlateralized attention, anosognosia), and the neuroanatomic substrates of neglect in patients with right hemisphere stroke in rehabilitation settings. Methods: The authors assessed 166 rehabilitation inpatients and outpatients with right hemisphere stroke with measures of neglect and neglect subtypes, attention, motor and sensory function, functional disability, and family burden. Detailed lesion analyses were also performed. Results: Neglect was present in 48% of right hemisphere stroke patients. Patients with neglect had more motor impairment, sensory dysfunction, visual extinction, basic ( nonlateralized) attention deficit, and anosognosia than did patients without neglect. Personal neglect occurred in 1% and peripersonal neglect in 27%, motor neglect in 17%, and perceptual neglect in 21%. Neglect severity predicted scores on the Functional Independence Measure and Family Burden Questionnaire more accurately than did number of lesioned regions. Conclusions: The neglect syndrome per se, rather than overall stroke severity, predicts poor outcome in right hemisphere stroke. Dissociations between tasks assessing neglect subtypes support the existence of these subtypes. Finally, neglect results from lesions at various loci within a distributed system mediating several aspects of attention and spatiomotor performance.