插画原创 | 小小青柠檬
汪洁 女,硕士,副主任技师。主要从事各型失语症与吞咽障碍的评价和治疗。现任“中国康复医学会康复治疗学会”常务委员、言语治疗学组顾问,中华医学会物理学与康复学分会第九届委员会言语语言康复学组委员。
曾获省部级、省卫生厅科技进步奖5项。参与“中国康复医学”、“脑血管病的康复治疗”、“神经康复学”等14部专著的编写,“实用语言治疗学”副主编)。在国家核心期刊发表失语症治疗等方面的论文60余篇。主要研究方向为失语症、吞咽障碍的经颅直流电刺激治疗。
神经外科学和影像学研究为动词的皮质定位提供了依据。Corina等[17]对13例神经外科患者进行了觉醒状态动作动词和物体名词神经表征的皮质定位研究。皮质刺激颞上回前部和颞中回造成名词命名不能,而造成动词命名不能的部位在患者间是不同的(颞上回中部、缘上回和颞中回后部)。Aggujaro等[18]的行为影像学研究结果显示,动词损害患者显示三种损伤类型:
①流利型失语症患者损伤了左半球颞叶后部和顶叶下部,这一临床资料与以前影像学报告的结果一致,即动词加工时激活顶叶[19]。颞叶后部和顶叶下部皮质是Wernicke's区与顶叶复杂动作计划表征之间的界面区[20—21]。该皮质区和该区皮质下白质的损害会产生突出的动词损害[22]。本组患者例3、例4为左颞顶、左颞损害,可见动词命名障碍。
②非流利型失语症患者具有左半球大面积病灶,全部损害了语言区;这类患者名词占优势的原因可能是右半球词汇知识的浮现,患者命名大部分局限于具体名词。本组患者中除例3、例4外,均含有左额颞顶大面积病灶。
③深部病灶涉及岛叶和皮质下白质。岛叶、外囊、丘脑和基底核病灶提示某种语言区的孤立,它决定了功能损害的模式,类似于广泛外侧裂病灶的损害。
参考文献:(滑动灰色区域,翻页查看)
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