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CLINICAL STUDY CONCERNING WITH A ROLE OF THE SUPPLEMENTARY MOTOR AREA AND CINGULATE MOTOR AREA IN HUMAN BEHAVIORAL CONTROL

辅助运动区和扣带运动区在人类行为控制中作用的临床研究

基本信息

批准号：
07670727
负责人：
TANAKA Yasufumi
金额：
$ 1.54万
依托单位：
JICHI MEDICAL SCHOOL
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
1995
资助国家：
日本
起止时间：
1995 至 1997
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-07670727/
关键词：
supplementary motor area anterior cingulate gyrus grasp reflex instincctive grasp reaction imitation behavior compulsive manipulation of tools

项目摘要

I investigated pathological grasping phenomena and related prehensile behavior in 34 patients with recent damage to a unilateral medial hemispheric wall from stroke. Phenomena were categorized as either the grasp reflex or the instinctive grasp reaction. The instinctive grasp reaction was subdivided into clothing reaction, final grip, trap reaction, magnet reaction, and visual groping. To determine the exact location and extent of the lesions, I examined magnet resonance images. The patients with damage involving the supplementary motor area, especially its caudal part, constantly exhibited the grasp reflex, mainly in the hand contralateral to the lesion. On the other hand, in the patients with damage involving the anterior cingulate gyrus, especially its middle and caudal parts, the groping movements such as the magnet reaction and visual groping of the instinctive grasp reaction were observed, mainly in the hand contralateral to the lesion. Other varieties of the instinctive grasp reaction were observed in the patients with damage to either the supplementary motor area or the anterior cingulate gyrus. These observations indicate that the grasp reflex is modulated mainly by the caudal part of the supplementary motor area, while the groping movements are primarily controlled by the middle and caudal parts of the anterior cingulate gyrus. I also found that some patients manifested, in addition to grasping movements, typical compulsive manipulation of tools placed on the table or shown before them, with the hand contralateral to the lesion. These patients continued to use objects until they restrained the movements using the other obedient hand. Such patients had severe, extensive damage to the anterior cingulate gyrus adjoining the genu and anterior body of the corpus callosum, as well as the callosal involvement.

我研究了34例中风后单侧半球内侧壁新近受损的患者的病理性抓握现象和相关抓握行为。这些现象被归类为抓握反射或本能抓握反应。将本能抓握反应细分为衣着反应、最后抓握反应、圈套反应、磁铁反应和视觉摸索。为了确定病变的确切位置和范围，我检查了磁共振图像。损害累及辅助运动区的患者，尤其是其尾部，经常表现出握力反射，主要发生在病变对侧的手。而受累于扣带回前部，尤其是中尾部受累的患者，可观察到本能抓握反应的磁铁反应和视觉摸索等摸索运动，主要发生在病变对侧手。在辅助运动区或扣带回前部受损的患者中，观察到其他类型的本能抓握反应。这些观察结果表明，抓握反射主要由辅助运动区的尾部调制，而摸索运动主要由扣带回前部的中部和尾部控制。我还发现，一些患者除了抓握动作外，还表现出典型的强迫性操作工具，放置在桌子上或展示在他们面前，手对侧病变。这些患者继续使用物体，直到他们用另一只听话的手限制动作。这些患者有严重的，广泛的损害的前扣带回毗邻膝盖骨和前体的穹隆体部，以及受累的膝盖骨。