基底神经节区梗死后失写症的神经心理学分析  

The Neuropsychological Analysis of Agraphia After Basal Ganglia Infarction

作　　者：金梅[1] 刘晓加[2] 陈东[2] 尹文刚 

机构地区：[1]解放军第171医院,九江332000 [2]南方医科大学南方医院神经内科,广州510515 [3]中国科学业院心理研究所,北京100080

出　　处：《国际脑血管病杂志》2008年第3期169-172,共4页International Journal of Cerebrovascular Diseases

基　　金：国家自然科学基金（No.30370486）

摘　　要：目的：研究基底神经节（BG）区梗死所致汉语失写症的神经心理学特点。方法：采用汉语失写检查法（CAB）测试40例BG区梗死患者的书写能力，计算各项书写得分和失写指数。对失写组和非失写组头颅CT或MRI进行标准化处理，显示病灶并进行二维平面叠加，直观显示其病灶的集中趋势。结果：在40例患者中，左侧BG区损害21例，失写17例；右侧损害19例，失写4例。神经影像学二维叠加显示，BG区梗死致失写的病灶多位于左侧BG区，包括左侧壳核、尾状核头部和尾状核体；而较少位于右侧壳核和右侧尾状核体。BG区梗死所致失写以失语性失写为主，其特点为构字障碍、字词错写和语法错误。结论：BG区梗死可导致失语性失写症，提示BG参与了书写加工过程，是书写这一高级神经功能的皮质下中枢。Objective： To investigate the neuropsychological characteristics of Chinese agraphia caused by basal ganglia （BG） infarction. Methods： The writing abilities of 40 patients with BG infarction were detected by Chinese agraphia battery （CAB）, and all the writing scores and agraphia quotient were calculated. The head CT/MRI images in agraphia and non-agraphia groups were standardized, the infarction were revealed and the superposition of two-dimensional arrays were performed, so that the central tendency of infarction was visually displayed. Results： Among the 40 patients, 21 had left BG infxaction, and 17 had agraphia; 19 had right BG infraction, and 4 had agraphia. The two-dimensional superimposing neuroimages showed that BG infarctions caused agraphia was mostly in the left BG, including the left putamen, the head and body of the caudate nucleus, but there were fewer infarctions in the right putamen and the body of the eaudatc nucleus. BG infarction caused agraphia was mostly aphasic agraphia, which was characterized by the orthographic disorders, paragraphia, and grammar mistakes. Conclvsions： BG infarction may result in aphasic agraphia, which suggested that BG is involed in writing and processing, and it is the subcortical center of this advanced neurofunction in writing.

关 键 词：脑梗死 基底神经节 失写症 神经心理学 

分 类 号：R743.3[医药卫生—神经病学与精神病学]