摘要目的 探讨忽视症(USN)患者的注意偏向.方法 将12例2009年9月至2011年7月来自安徽医科大学第一附属医院的右脑卒中伴忽视(USN+)患者及与其人口学资料相匹配的12例右脑卒中不伴忽视(USN -)患者和20名健康志愿者(HC)作为研究对象,采用灰度判别试验进行注意偏移度测查.结果 USN+组与USN -组、HC组的忽视症筛查测试结果差异有统计学意义[线段划消:USN+组(-0.56 ±0.39)分,USN -组(0.00±0.00)分,HC组(0.00 ±0.00)分,F(2,41)=33.708,P＜0.001；线等分:USN+组(0.28 ±0.29)分,USN -组(0.03±0.04)分,HC组(- 0.02±0.04)分,F(2,41)=14.527,P＜0.001;自发画钟:USN+组(3.58±4.03)分,USN -组(0.08±0.29)分,HC组(0.00 ±0.00)分,F(2,41)=12.558,P＜0.001;临摹画花:USN+组(0.83±0.65)分,USN -组(0.13±0.23)分,HC组(0.00±0.00)分,F(2,41) =21.621,P＜0.001].脑损伤部位频率图比较显示,USN+组患者脑损伤部位以右颞顶交界区为主,USN -组患者脑损伤部位基本不涉及颞顶交界区.灰度判别试验中USN+组、USN -组和HC组的注意偏移度分别为(0.92±0.11)分,(0.41 ±0.12)分,(-0.28 ±0.15)分,结果提示HC组注意左偏,USN+及USN -组均注意右偏,3组间差异具有统计学意义(F(2,41)=334.324,P＜0.001)；进一步两两比较发现,USN+组注意右偏程度大于USN -组(P＜0.001).USN患者的灰度判别试验结果与预期忽视相符.结论 USN患者存在明显注意右偏,这种注意偏向可能与右脑颞顶交界区损伤有关.

abstractsObjective To explore the attentional bias in unilateral spatial neglect (USN) patients.Methods The grey discriminant test was conducted on 12 right-brain-damaged patients with USN (USN + ),12 right-brain-damaged patients with no evidence of USN ( USN - ) and 20 health controls (HC).They were matched for age,years of education,mini-mental state examination (MMSE) scores and handedness.And all patients were recruited from First Affiliated Hospital of Anhui Medical University.The attentional deviation scores were compared between three groups. Results The differences in scores of neglect tests for the USN +,USN - and HC groups were significant ( Albert test:USN + group - 0.56 ± 0.39,USN - group 0.00 ± 0.00,HC group 0.00 ± 0.00,F(2,41 ) =33.708,P ＜ 0.001 ; line bisection test:USN+ group0.28 ±0.29,USN- group 0.03 ±0.04,HC group -0.02 ±0.04,F(2,41) =14.527,P ＜ 0.001 ; clock drawing by memory:USN + group 3.58 ± 4.03,USN - group 0.08 ± 0.29,HC group 0.00 ± 0.00,F(2,41 ) =12.558,P ＜ 0.001 ; daisy copying:USN + group 0.83 ± 0.65,USN -group 0.13±0.23,HC group 0.00 ±0.00,F(2,41) =21.621,P＜0.001).The comparative results of lesion locations showed that USN + patients were predominantly related to lesions in temporal-parietal junction.The attentioanl deviation scores for the USN +,USN - and HC groups were 0.92 ±0.11,0.41 ±0.12 and -0.28 ±0.15 respectively.The difference was significant ( F(2,41 ) =334.324,P ＜ 0.001 ).There was a small leftward bias in the HC group and a rightward bias in the USN + and USN - groups.LSD test revealed that the USN + group displayed a rightward bias much strongerly than the USN - group ( P ＜0.001 ).And the results of grey discriminant test were consistent with the neglect symptoms.Conclusion The USN patients show a marked attentional bias toward the right side of space.And it may be attributed to the dysfunction of temporal-parietal junction.