非自我为中心的偏侧忽略的发生及其解剖

目的:研究非自我为中心的空间忽略在整个忽略人群中的分布及其发生相关的解剖位点。方法:对55例右侧脑损伤后合并左侧空间忽略的患者进行不同参考框架下的分型,根据分型结果将忽略患者分为自我为中心的忽略亚组及合并非自我为中心和自我为中心的忽略亚组,比较两个亚组的临床特征,并利用MRIcro软件将两个亚组的头颅脑成像显示的病灶分别进行叠加和相减分析。结果:47例患者接受了分型测试,其中30例(63.83%)患者合并存在非自我为中心的忽略和自我为中心的忽略,17例患者表现为单纯的自我为中心的忽略。两个亚组的一般状况及临床特征比较无显著性差异。两个亚组的病灶部位相比,右侧颞上回、颞中回及豆状核的损伤在非自我为中心的忽略亚组更常见。结论:右侧脑损伤后存在左侧空间忽略的患者一半以上合并存在非自我为中心的忽略。非自我为中心的左侧空间忽略的发生与右侧颞上回、颞中回、豆状核及周围白质的损伤相关。

Study on occurrence and anatomic bases of allocentric spatial neglect

Abstract Objective: To study the distribution of allocentric neglect among the neglect population and its anatomic bases. Method: Fifty-five subjects with left spatial neglect after right brain injury were recruited, and grouped into two subgroups according to different reference frames: egocentric neglect subgroup and combined egocentric and allocentric neglect subgroup. The clinical and general features between the two subgroups were compared, as well as the lesions of two subgroups revealed on the brain images were analyzed with MRIcro software. Result: Forty-seven out of 55 subjects were grouped, of which 30 (63.83%) subjects with combined allocentric and egocentric neglect and 17 subjects with pure egocentric neglect. The difference in general and clinical features between the two subgroups was not significant statistically. Fifty-four comparison of leisons sites between two subgroups, the lesions in right superior temporal gyrus, middle temporal gyrus, lenticular nucleus and the surrounding white matter, were damaged more frequently in allocentric neglect subgroup. Conclusion: More than half subjects with left neglect following right brain injury were combined with allocentric neglect. Allocentric neglect is associated with lesions in right superior temporal gyrus, middle temporal gyrus, lenticular nucleus and the surrounding white matter.