Dissociating Components of the Attentional Network in Neglect

忽视时注意力网络的分离成分

基本信息

批准号：
7473953
负责人：
Christopher Rorden
金额：
$ 28.31万
依托单位：
UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA
依托单位国家：
美国
项目类别：
财政年份：
2006
资助国家：
美国
起止时间：
2006-07-01 至 2011-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7473953
关键词：
Activities of Daily Living Affect American Area Attention Auditory Perception Back Behavioral Brain Brain Injuries Brain region Clinical Cognitive Complex Consensus Cues Depth Disruption Eating Economics Extinction (Psychology)Face Failure Food Fractionation Functional Magnetic Resonance Imaging Functional disorder Goals Hand Human Individuation Injury Insula of Reil Lead Left Lesion Literature Location Logistic Regressions Motor Nature Neuropsychological Tests Neuropsychology Outcome Patients Pattern Perfusion Persons Physiologic pulse Process Pulse taking Quality of life Range Recovery Rehabilitation therapy Reporting Research Personnel Role Sampling Severities Side Stroke Structure Superior temporal gyrus Symptoms Syndrome System Techniques Testing Time Transcranial magnetic stimulation Visual Visual Fields Visual Perception Work base clinically significant design frontal eye fields hemisphere damage improved insight intraparietal sulcus neglect outcome forecast programs rehabilitation strategy relating to nervous system research study stroke recovery volunteer

项目摘要

DESCRIPTION (provided by applicant): Brain damage following stroke affects many Americans, having a major impact on quality of life and the ability to carry out activities of daily life. To minimize the human and economic impact of stroke, the factors that predict recovery and successful rehabilitation need to be understood. Visual neglect is a common consequence of brain damage to the right hemisphere, and the presence of this symptom (or syndrome) is a major predictor of poor clinical outcomes. Visual neglect is a clinical deficit of attention, in which the person fails to notice, or to respond to items opposite the lesion. So a person with a stroke to the right hemisphere may eat from only the right hand side of their plate, ignoring the food on the left, or may shave only the right side of their face, and so on. Neglect has been studied for many years, in part for its major clinical significance, but also because it has the potential to provide insight into brain mechanisms of attention. The most common, severe and enduring neglect follows damage to the right hemisphere, leading to neglect of the left. The presence of right neglect is more controversial, and of lesser clinical significance. For these reasons, the present study is confined to studies of left neglect due to right hemisphere damage. The two most fundamental questions about neglect remain unanswered, and the subject of deep controversy in the scientific literature. Simply stated, these are: what is the nature of the deficit? and what are the key areas of brain damage that cause neglect? We propose a simple theoretical framework for answering these questions and providing rapprochement for the divergent views of attention. We propose that visual neglect is a complex syndrome that is nonetheless dissociable into sets of deficits that result from damage to, or dysfunction of, four regions of the cortex. These four cortical regions represent discreet, yet interconnected modules in the attentional network of the brain. The intraparietal sulcus is a region involved in determining the global structure of items, and responding to them; damage to this region is associated with bias on the line bisection task. The temporal operculum and insula (a region often referred to as superior temporal gyrus) is involved in orienting to items; damage to this region will lead to errors on the line cancellation task. The temporoparietal junction is involved in assigning salience to items; damage to this region will lead to visual extinction - a failure to report items in the impaired visual field only if there are items in the good field. Finally the frontal eye fields are regions primarily concerned with perceptual inhibition; damage to this region will lead to increased distractibility. We propose that the controversies over the core areas and symptoms are due to variability in sampling patients with damage to these four systems. The present study tests these predictions by converging use of neuropsychology, functional MRI, and transcranial magnetic stimulation in normal observers.

描述（由申请人提供）：中风后的大脑损伤会影响许多美国人，对生活质量和日常生活活动的能力产生重大影响。为了最大程度地减少中风的人类和经济影响，需要理解预测恢复和成功康复的因素。视觉忽视是脑对右半球损害的普遍结果，而这种症状（或综合征）的存在是临床不良结局的主要预测指标。视觉忽视是注意力的临床赤字，其中该人没有注意到或对病变相对的物品做出反应。因此，一个右半球中风的人可能只能从盘子的右侧进食，忽略左侧的食物，或者只能剃光脸的右侧，依此类推。忽视已经进行了多年的研究，部分原因是它的主要临床意义，但这也是因为它有可能洞悉注意力的注意力机制。最常见，严重和持久的忽视遵循对右半球的损害，导致左侧的忽视。正确忽视的存在更具争议性，并且具有较小的临床意义。由于这些原因，本研究仅限于由于右半球损害而导致的左忽视研究。关于忽视的两个最根本的问题仍然没有得到答复，并且在科学文献中引起了深刻争议。简而言之，这些是：赤字的本质是什么？导致忽视的脑损伤的关键领域是什么？我们提出了一个简单的理论框架，用于回答这些问题并为注意力的观点提供和解。我们建议视觉忽视是一种复杂的综合征，尽管如此，由于皮质的四个区域的损坏或功能障碍而导致的一组缺陷集。这四个皮质区域代表了大脑注意网络中的谨慎但相互联系的模块。腔内沟是一个涉及确定项目的全球结构并响应它们的地区。对该区域的损坏与线一分解任务上的偏差有关。颞孔和岛（通常称为上级颞回）与项目定向有关。对该区域的损坏将导致线取消任务的错误。颞叶交界处参与将显着性分配给项目；对该区域的损坏将导致视觉灭绝 - 仅在良好场中有项目时，仅在视觉场中报告项目。最后，额叶田地是主要涉及感知抑制的区域。对该区域的损害将导致分散注意力的增加。我们提出，核心区域和症状的争议是由于对这四个系统损坏的患者进行了差异。本研究通过在正常观察者中融合使用神经心理学，功能性MRI和经颅磁刺激来测试这些预测。