汉语失写症的神经心理学研究及其意义

目的 探讨汉语失写症的神经心理语言学机制以及该研究对于汉语失写症病理行为的康复学意义。方法 采用汉语失语检查法和汉语失写检查法测试口语和书写能力，详细记录患者的书写、失写行为特征，区分言语障碍类型；运用计算机图像处理技术对病灶CT／MRI图像进行标准化、二维叠加、三维重建等处理，并与非失写对照组相减，显示不同失写类型病变的集中趋势。结果 左侧半球损害48例，其中失语30例，失写32例，后者中纯失写1例，失读并失写1例；右侧半球损害15例，其中失语失写3例。具体的资料分析表明：不同的失写类型有不同的病理行为特点。计算机图像处理结果显示：失语性失写病灶较集中的区域为左额顶叶深部白质。惰性失写主要集中在左外侧裂的前方、从额中下回向后部延伸。镜像书写则分散于左丘脑、基底节附近。结论 汉语失写症的病理行为特点与病损定位有密切的关系；双通道理论有可能符合汉语语言学机制；汉语失写症的神经心理学研究对汉语失写康复模式的制定有重要意义。

The neuropsychologic study of chinese agraphia and its meaning

Objective To explore the neurolinguistic and psychological mechanism of Chinese agraphia and also the rehabilitation significance of the study to the pathological behavior of agraphia. Methods ABC and CAB were used to examine the ability of oral language and writing. The characters of writing were recorded. Different types of aphasia and agraphia were classified. Computerized image processing technology was used to standardize and reconstruct the skull CT/ MRI images. The results substracted from the normal controls were showed directly. Results 48 patients were injuried left in which 30 were aphasic and 32 were agraphic, 15 were injuried right in which 3 were aphasic and agraphic. Analysis of data showed Different kind of agraphia had different pathological behavior character. The image processing results showed that nidi of aphasic agraphia focused on the left deep albae of frontal and parietal lobe; nidi of persistent agraphia focused on the posterior parts of the left 1st and 2nd of frontal lobe, nidi of mirror writing were dispersed near the left basal ganglion and thalamus. Conclusions Chinese agraphia has a close relation with the location of brain damage, and Two passage Theory may be applicable to the Linguistic mechanism of Chinese. Study of Chinese agrphia is most significant to work out its rehabilitation model.