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Deficient allo-centric visuospatial processing contributes to apraxic deficits in sub-acute right hemisphere stroke.
Journal of Neuropsychology ( IF 2.2 ) Pub Date : 2019-06-17 , DOI: 10.1111/jnp.12191
Simon D Ubben 1 , Gereon R Fink 1, 2 , Stephanie Kaesberg 2 , Elke Kalbe 3 , Josef Kessler 2 , Simone Vossel 1, 4 , Peter H Weiss 1, 2
Affiliation  

While visuospatial deficits are well‐characterized cognitive sequelae of right hemisphere (RH) stroke, apraxic deficits in RH stroke remain poorly understood. Likewise, very little is known about the association between apraxic and visuospatial deficits in RH stroke or about the putative common or differential pathophysiology underlying these deficits. Therefore, we examined the behavioural and lesion patterns of apraxic deficits (pantomime of object use and bucco‐facial imitation) and visuospatial deficits (line bisection and letter cancellation tasks) in 50 sub‐acute RH stroke patients. Using principal component analysis (PCA), we characterized the relationship between the two deficits. We hypothesized that any interaction of these neuropsychological measures may be influenced by the demands of ego‐centric/space‐based and/or allo‐centric/object‐based processing. Contralesional visuospatial deficits were common in our clinically representative patient sample, affecting more than half of RH stroke patients. Furthermore, about one‐third of all patients demonstrated apraxic deficits. PCA revealed that pantomiming and the imitation of bucco‐facial gestures loaded clearly on a first component (PCA1), while letter cancellation loaded heavily on a second component (PCA2). For line bisection, overall mean deviation loaded on PCA1, while the difference between the mean deviations in contra‐ versus ipsilesional space loaded on PCA2. These results suggest that PCA1 represents allo‐centric/object‐based processing and PCA2 ego‐centric/space‐based processing. This interpretation was corroborated by the statistical lesion analyses with the component scores. Data suggest that disturbed allo‐centric/object‐based processing contributes to apraxic pantomime and imitation deficits in (sub‐acute) RH stroke.

中文翻译:

异位为中心的视觉空间处理不足会导致亚急性右半球卒中的顶体功能减退。

尽管视觉空间缺陷是右半球(RH)中风的特征性认知后遗症,但对RH中风的先天性缺陷仍知之甚少。同样,关于RH脑卒中的先天性和视觉空间缺陷之间的相关性或这些缺陷背后的常见或差异性病理生理学知之甚少。因此,我们检查了50例亚急性RH脑卒中患者的先兆缺陷(使用对象的手势和颊面模仿)和视觉空间缺陷(线对分和字母取消任务)的行为和病变模式。使用主成分分析(PCA),我们表征了两个缺陷之间的关系。我们假设这些神经心理学措施的任何相互作用都可能受到以自我为中心/基于空间和/或基于同心为中心/基于对象的处理的需求的影响。在我们具有临床代表性的患者样本中,腹腔镜视空缺损很常见,影响了一半以上的RH脑卒中患者。此外,所有患者中约有三分之一表现出了前肢缺损。PCA揭示,手势模仿和颊面部手势模仿在第一个组件(PCA1)上清晰可见,而字母消除功能在第二个组件(PCA2)上清晰可见。对于线平分线,在PCA1上加载整体平均偏差,而在PCA2上加载对侧空间与同侧空间的平均偏差之间的差。这些结果表明,PCA1代表以同心为中心/基于对象的处理,而PCA2代表以自我为中心/基于空间的处理。统计解释与成分评分一起证实了这一解释。数据表明,以异基因为中心/以对象为基础的处理受累会导致(亚急性)RH中风的肢体哑剧和模仿缺陷。
更新日期:2019-06-17
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