在第一次脑损伤后,失方向的解剖学和功能预测因素
Alexandra Adam-Darque1, Radek Ptak1, Stephan Schneider1
1Laboratory of Cognitive Neurorehabilitation, Division of Neurorehabilitation, Department of Clinical Neurosciences, University Hospital and University of Geneva, 1211, Geneva 14, Switzerland.
Neuropsychologia
|June 1, 2023
概括
脑损伤后的迷失方向与现实过和记忆问题受损有关,而不是执行功能障碍. 轨道前皮层和尾状核的损伤是关键的解剖原因.
科学领域:
- 神经科学是一个神经科学.
- 神经学 神经学
- 认知心理学 认知心理学
背景情况:
- 迷失方向是急性脑损伤后或像痴呆症这样的扩散性脑疾病中常见的症状.
- 迷失方向的潜在机制和精确的解剖相关性仍在争论中.
- 虽然通常认为记忆障碍是主要原因,但另一种假设表明轨道前端现实过 (ORFi) 失败.
研究的目的:
- 调查第一次亚急性脑损伤的患者的迷失方向的机制和解剖基础.
- 为了区分记忆功能障碍和轨道前端现实过缺陷作为迷失方向的原因.
- 使用病变-症状映射识别,识别与迷失方向相关的特定大脑区域.
主要方法:
- 一项观察性队列研究包括84名有史以来首次有机半球大脑功能障碍的患者.
- 用20项问卷来评估方向性.
- 轨道前置现实过 (ORFi) 使用连续识别任务进行了评估,评估时间上下文混,物品识别和延迟自由回忆. 损伤症状映射 (LSM) 用于识别解剖学预测因素.
主要成果:
- 时间上下文混,物品识别和延迟的自由回忆是迷失方向的重要预测因素.
- 在67名参与者中,损伤症状映射显示了迷失方向和右轨道前皮层 (OFC) 和尾状核的双边头部损伤之间的强烈关联.
- 迷失方向与ORFi受损和记忆功能障碍有关,但不是执行功能障碍.
结论:
- 在有史以来首次脑损伤的患者中,迷失方向与轨道前额现实过功能受损和记忆缺陷有关.
- 在这个群体中,执行功能障碍并不是失调的重要预测因素.
- 迷失方向的主要解剖学决定因素是轨道前皮层及其下皮层连接的病变,特别是尾状核的头部.
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