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岳月红,齐亚超,赵永波,王彦芝,段瑞生,肖向建,刘昌林,宋为群.偏侧空间忽略发生的相关解剖位点研究[J].中国康复医学杂志,2015,(11):1125~1130
偏侧空间忽略发生的相关解剖位点研究    点此下载全文
岳月红  齐亚超  赵永波  王彦芝  段瑞生  肖向建  刘昌林  宋为群
河北省人民医院神经内科,石家庄市,050000
基金项目:
DOI:
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摘要:
      摘要 目的:探讨右侧半球脑卒中后左侧偏侧空间忽略的临床及相关的大脑解剖位点。 方法:本研究收集了120例右侧脑卒中患者,其中60例左侧空间忽略患者(忽略组)及60例右侧半球卒中后无忽略的患者(对照组),进行病例对照研究,分析两组的临床特征,并运用MRIcro软件对两组研究对象的头颅影像结果进行分析,分别将两组患者的颅内病灶进行叠加,继后相减,并进行基于体素的卡方分析,进而探讨哪些脑区的损伤几率在忽略组高于对照组。 结果:忽略组与对照组相比,性别构成、年龄、偏盲几率、受教育年数、病程、接受影像检查时间差异无显著性意义(P>0.05);忽略组的病灶体积显著大于对照组(P<0.05),MMSE得分显著低于对照组(P<0.05);两组的头颅病灶分析显示:额下回、中央前回、中央后回、颞上回、颞中回、脑岛及其周围白质、顶下小叶白质的损伤的发生率,忽略组显著高于对照组。 结论:右侧脑卒中患者中,发生忽略的患者病灶体积更大,MMSE得分更低。忽略的发生与额下回、中央前回、中央后回、颞上回、颞中回、脑岛及其周围白质及其顶下小叶白质的损伤相关。
关键词:偏侧空间忽略  认知障碍  解剖
A study on the neuroanatomic bases of hemispatial neglect    Download Fulltext
Dept. of Neurology, Hebei General Hospital, Shijiazhuang City, 050000
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Abstract:
      Abstract Objective: To investigate the clinical and neuroanatomic bases of left hemispatial neglect after right cerebral hemispheric stroke. Method: One hundred and twenty subjects of right cerebral hemispheric stroke were recruited, with 60 left spatial neglect (case group) and 60 controls without neglect. Their clinical features were analyzed. The lesions on head imaging of both groups were superposed respectively, and then subtracted from each other, analyzed with chi-squared analysis by the voxelwise statistical tests with MRIcro software. Result: The difference of the two groups was not significant in sex composition, age, the hemianopsia ratio, duration length, length of disease course, length of imaged since onset (P>0.05). Compared with the control group, areas of the lesions were larger in the neglect group (P<0.05); Scores of MMSE in the neglect group were significantly lower (P<0.05). The lesions in the following areas were more frequent in the neglect group than that in the control group, including inferior frontal gyrus, precentral gyrus, postcentral gyrus, superior temporal gyrus, middle temporal gyrus, insular and white matters surrounding, and the white matter under inferior parietal lobe. Conclusion: Subjects with neglect showed much larger lesion area and lower MMSE scores than ones without neglect after right hemispheric stroke. The occurrence of left spatial neglect with right hemispheric stroke might be related to damages in the following areas, including inferior frontal gyrus, precentral gyrus, postcentral gyrus, superior temporal gyrus, middle temporal gyrus, insular and white matters surrounding, and the white matter under inferior parietal lobe.
Keywords:hemispatial neglect  cognitive impairment  anatomy
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