The anatomy of visual neglect
The anatomy of visual neglect
复制标题
DOI：
10.1093/brain/awg200
复制
发表时间：
2003-09-01
期刊：
影响因子：
14.5
通讯作者：
Husain, M
中科院分区：
文献类型：
--
作者：
Mort, DJ;Malhotra, P;Husain, M
与视觉忽视密切相关的大脑区域一直备受争议。特别是一项对大脑中动脉（MCA）中风患者的研究声称，与忽视相关的关键大脑区域是右侧大脑半球外侧面的颞上回（STG）中部，而非顶叶后部。这样的结果对我们理解这些皮质区域的正常功能以及忽视潜在机制都具有广泛的影响。在此，我们使用新型高分辨率磁共振成像方案绘制了35名患有大脑中动脉或大脑后动脉（PCA）区域中风的右侧大脑半球患者的病变图。对于大脑中动脉区域中风的患者，所有忽视患者涉及的关键区域是顶下小叶（IPL）的角回。尽管我们研究的一半大脑中动脉忽视患者的颞上回受损，但其余患者的该区域未受损。对于大脑后动脉区域中风的患者，所有忽视患者的病变都涉及颞叶内侧面的海马旁回区域。没有忽视症状的大脑后动脉患者该区域没有受损。我们得出结论，两个后部区域受损与忽视相关，一个在顶下小叶，另一个在颞叶内侧。尽管一些忽视患者的颞上回确实受损，但我们的研究结果对近期有影响力的观点提出了质疑，即该区域的病变与忽视密切相关。相反，我们的结果表明角回和海马旁回区域在其中起作用。
The brain regions that are critically associated with visual neglect have become intensely disputed. In particular, one study of middle cerebral artery (MCA) stroke patients has claimed that the key brain region associated with neglect is the mid portion of the superior temporal gyrus (STG), on the lateral surface of the right hemisphere, rather than the posterior parietal lobe. Such a result has wide-ranging implications for both our understanding of the normal function these cortical areas and the potential mechanisms underlying neglect. Here, we use novel high resolution MRI protocols to map the lesions of 35 right-hemisphere patients who had suffered either MCA or posterior cerebral artery (PCA) territory stroke. For patients with MCA territory strokes, the critical area involved in all neglect patients was the angular gyrus of the inferior parietal lobe (IPL). Although the STG was damaged in half of our MCA neglect patients, it was spared in the rest. For PCA territory strokes, all patients with neglect had lesions involving the parahippocampal region, on the medial surface of the temporal lobe. PCA patients without neglect did not have damage to this area. We conclude that damage to two posterior regions, one in the IPL and the other in the medial temporal lobe, is associated with neglect. Although some neglect patients do have damage to the STG, our findings challenge the recent influential proposal that lesions of this area are critically associated with neglect. Instead, our results implicate the angular gyrus and parahippocampal region in this role.