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Dissociation of visual extinction and neglect in the left hemisphere.
Cortex ( IF 3.2 ) Pub Date : 2020-04-28 , DOI: 10.1016/j.cortex.2020.04.010
Lena-Alexandra Beume 1 , Michel Rijntjes 1 , Andrea Dressing 1 , Christoph P Kaller 1 , Maren Hieber 1 , Markus Martin 1 , Simon Kirsch 2 , Dorothee Kümmerer 1 , Horst Urbach 3 , Roza M Umarova 4 , Cornelius Weiller 1
Affiliation  

Visual neglect and extinction are two distinct visuospatial attention deficits that frequently occur after right hemisphere cerebral stroke. However, their different lesion profiles remain a matter of debate. In the left hemisphere, a domain-general dual-loop model with distinct computational abilities onto which several cognitive functions may project, has been proposed: a dorsal stream for sensori-motor mapping in time and space and a ventral stream for comprehension and representation of concepts. We wondered whether such a distinction may apply to visual extinction and neglect in left hemisphere lesions. Of 165 prospectively studied patients with acute left hemispheric ischemic stroke with a single lesion on MRI, 122 had no visuospatial attention deficit, 10 had extinction, 31 neglect and 2 had both, visual extinction and neglect. Voxel-based-lesion-symptom mapping (VLSM, FDR<.05) showed a clear anatomical dissociation. Extinction occurred after damage to the parietal cortex (anterior bank of the intraparietal sulcus, inferior parietal lobe, and supramarginal gyrus), while visual neglect occurred after damage mainly to the temporal lobe (superior and middle temporal lobe, anterior temporal pole), inferior ventral premotor cortex, frontal operculum, angular gyrus, and insula. Direct comparison of both conditions linked extinction to intraparietal sulcus and supramarginal gyrus (FDR<.05). Thus, in the left hemisphere extinction seems to be related to dorsal stream lesions, whereas neglect maps more on the ventral stream. These data cannot be generalized to the right hemisphere. However, a domain-general point-of-view may stimulate discussion on visuospatial attention processing also in the right hemisphere.



中文翻译:

左半球视觉消失和疏忽消失。

视觉疏忽和消光是右半球脑卒中后经常发生的两个明显的视觉空间注意力缺陷。然而,它们不同的病变轮廓仍然是争论的问题。在左半球,提出了一个具有不同计算能力的领域通用双环模型,几个认知功能可以投射到该模型上:用于时空感觉运动映射的背侧流,用于理解和表示腹侧的腹侧流概念。我们想知道这样的区别是否可能适用于左半球病变的视觉消失和忽视。165名接受MRI单个病变的急性左半球缺血性卒中的前瞻性研究患者中,122例无视空间注意力缺陷,10例已消失,31例被忽视,2例均在视觉上消失和被忽视。基于体素的病变症状图谱(VLSM,FDR <.05)显示出清晰的解剖分离。顶叶皮层(顶壁内沟前壁,顶壁下叶和上弓状回)损伤后即灭绝,而视神经疏忽主要发生在颞叶(上,中颞叶,前颞极),下腹侧运动前皮层,额,角回和绝缘。两种情况的直接比较将绝种与顶壁内沟和上颌上回相关(FDR <.05)。因此,在左半球的灭绝似乎与背侧流病变有关,而忽略则更多地在腹侧流上。这些数据不能推广到右半球。然而,

更新日期:2020-04-28
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