Dissociating Components of the Attentional Network in Neglect

忽视时注意力网络的分离成分

• 批准号: 7473953
• 负责人: Christopher Rorden
• 金额: $ 28.31万
• 依托单位: UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-07-01 至 2011-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7473953
• 关键词: Activities of Daily Living; Affect; American; Area; Attention; Auditory Perception; Back; Behavioral; Brain; Brain Injuries; Brain region; Clinical; Cognitive; Complex; Consensus; Cues; Depth; Disruption; Eating; Economics; Extinction (Psychology); Face; Failure; Food; Fractionation; Functional Magnetic Resonance Imaging; Functional disorder; Goals; Hand; Human; Individuation; Injury; Insula of Reil; Lead; Left; Lesion; Literature; Location; Logistic Regressions; Motor; Nature; Neuropsychological Tests; Neuropsychology; Outcome; Patients; Pattern; Perfusion; Persons; Physiologic pulse; Process; Pulse taking; Quality of life; Range; Recovery; Rehabilitation therapy; Reporting; Research Personnel; Role; Sampling; Severities; Side; Stroke; Structure; Superior temporal gyrus; Symptoms; Syndrome; System; Techniques; Testing; Time; Transcranial magnetic stimulation; Visual; Visual Fields; Visual Perception; Work; base; clinically significant; design; frontal eye fields; hemisphere damage; improved; insight; intraparietal sulcus; neglect; outcome forecast; programs; rehabilitation strategy; relating to nervous system; research study; stroke recovery; volunteer

DESCRIPTION (provided by applicant): Brain damage following stroke affects many Americans, having a major impact on quality of life and the ability to carry out activities of daily life. To minimize the human and economic impact of stroke, the factors that predict recovery and successful rehabilitation need to be understood. Visual neglect is a common consequence of brain damage to the right hemisphere, and the presence of this symptom (or syndrome) is a major predictor of poor clinical outcomes. Visual neglect is a clinical deficit of attention, in which the person fails to notice, or to respond to items opposite the lesion. So a person with a stroke to the right hemisphere may eat from only the right hand side of their plate, ignoring the food on the left, or may shave only the right side of their face, and so on. Neglect has been studied for many years, in part for its major clinical significance, but also because it has the potential to provide insight into brain mechanisms of attention. The most common, severe and enduring neglect follows damage to the right hemisphere, leading to neglect of the left. The presence of right neglect is more controversial, and of lesser clinical significance. For these reasons, the present study is confined to studies of left neglect due to right hemisphere damage. The two most fundamental questions about neglect remain unanswered, and the subject of deep controversy in the scientific literature. Simply stated, these are: what is the nature of the deficit? and what are the key areas of brain damage that cause neglect? We propose a simple theoretical framework for answering these questions and providing rapprochement for the divergent views of attention. We propose that visual neglect is a complex syndrome that is nonetheless dissociable into sets of deficits that result from damage to, or dysfunction of, four regions of the cortex. These four cortical regions represent discreet, yet interconnected modules in the attentional network of the brain. The intraparietal sulcus is a region involved in determining the global structure of items, and responding to them; damage to this region is associated with bias on the line bisection task. The temporal operculum and insula (a region often referred to as superior temporal gyrus) is involved in orienting to items; damage to this region will lead to errors on the line cancellation task. The temporoparietal junction is involved in assigning salience to items; damage to this region will lead to visual extinction - a failure to report items in the impaired visual field only if there are items in the good field. Finally the frontal eye fields are regions primarily concerned with perceptual inhibition; damage to this region will lead to increased distractibility. We propose that the controversies over the core areas and symptoms are due to variability in sampling patients with damage to these four systems. The present study tests these predictions by converging use of neuropsychology, functional MRI, and transcranial magnetic stimulation in normal observers.

描述（由申请人提供）：中风后的脑损伤影响着许多美国人，对生活质量和进行日常生活活动的能力产生重大影响。为了最大限度地减少中风对人类和经济的影响，需要了解预测康复和成功康复的因素。视力忽视是右半球脑损伤的常见后果，这种症状（或综合征）的存在是不良临床结果的主要预测因素。视觉忽视是一种临床注意力缺陷，即患者无法注意到或无法对病变对面的物体做出反应。因此，右半球中风的人可能只从盘子的右侧吃饭，而忽略左侧的食物，或者可能只刮脸的右侧，等等。忽视已经被研究了很多年，部分原因是其重要的临床意义，而且还因为它有可能提供对大脑注意力机制的深入了解。最常见、最严重和持久的忽视是右半球受损，导致左半球被忽视。右侧忽视的存在更具争议性，且临床意义较小。由于这些原因，本研究仅限于对右半球损伤导致的左侧忽视的研究。关于忽视的两个最基本的问题仍未得到解答，并且是科学文献中存在深刻争议的主题。简单地说，这些是：赤字的性质是什么？导致忽视的大脑损伤的关键区域是什么？我们提出了一个简单的理论框架来回答这些问题并为不同的关注观点提供和解。我们认为，视觉忽视是一种复杂的综合征，但它可以分解为由皮层四个区域的损伤或功能障碍引起的一系列缺陷。这四个皮质区域代表大脑注意力网络中离散但相互关联的模块。顶内沟是一个参与确定项目的整体结构并对其做出反应的区域；该区域的损坏与线平分任务的偏差有关。颞盖和岛叶（通常称为颞上回的区域）参与对物品的定向；该区域的损坏将导致线路错误取消任务。颞顶交界处参与分配项目的显着性；该区域的损坏将导致视力丧失——仅当良好视野中有物体时，才无法报告受损视野中的物体。最后，额眼区域主要与知觉抑制有关。该区域的损坏将导致注意力更加分散。我们认为，关于核心领域和症状的争议是由于这四个系统受损的患者样本的差异造成的。本研究通过在正常观察者中综合使用神经心理学、功能性 MRI 和经颅磁刺激来测试这些预测。