PDF(Pubmed)
Abstract：
Visuospatial neglect is a heterogenous syndrome which can occur following damage to either right or left hemisphere areas. This study employs voxel-lesion symptom mapping to identify the neural correlates of left and right egocentric and allocentric neglect in a large acute stroke cohort. A cohort of 446 acute stroke survivors (age = 26-95, 44% female) completed neuropsychological neglect assessment and routine clinical imaging. Similar to previous investigations, left egocentric and left allocentric neglect were associated with damage to distinct clusters of voxels within the posterior parietal and temporo-parietal junction areas. Unlike previous investigations, right egocentric neglect was found to most strongly associated with damage to more posterior voxels within left occipital cortical areas. Right allocentric neglect was found to be most strongly associated with damage to the anterior limb of the left internal capsule. Interestingly, the right hemisphere homologues of the areas implicated in right-lateralised neglect were not overlapping with those associated with left neglect impairment. This dissociation was present across both egocentric and allocentric neglect impairment. The results of this investigation suggest that right egocentric/allocentric neglect should not be characterised as a consequence of damage to left-hemisphere homologues of the right hemisphere attentional systems. These findings support the characterisation of visuospatial neglect as a heterogenous cluster of impairments rather than a unitary syndrome and provide novel insight into the neural correlates of spatial attention.
摘要：
视觉空间忽视是一种异质性综合征，可在右半球或左半球区域受损后发生。这项研究采用体素-病变症状映射来识别大型急性中风队列中左右自我中心和非中心忽视的神经相关性。由446名急性卒中幸存者组成的队列（年龄=26-95岁，女性44％）完成了神经心理学忽视评估和常规临床影像学检查。类似于以前的调查，左心中心和左心中心的忽视与后顶叶和颞顶叶交界处区域内不同体素簇的损害有关。与以前的调查不同,发现右以自我为中心的忽视与左枕骨皮质区域内更多后体素的损伤密切相关。发现右非中心的忽视与左内囊前肢的损伤最密切相关。有趣的是,与右侧忽视有关的区域的右半球同源物与与左侧忽视损害相关的区域不重叠.这种分离存在于自我中心和非中心忽视损害中。这项研究的结果表明，不应将右自我中心/非中心的忽视描述为对右半球注意系统的左半球同源物的损害。这些发现支持将视觉空间忽略表征为异质的损伤簇，而不是单一的综合征，并提供了对空间注意力的神经相关性的新颖见解。
