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线索提示在对消症和忽视症康复中的作用研究

发布时间:2018-12-12 05:30
【摘要】:目的脑损伤患者会遗留多种认知功能障碍,右侧脑卒中患者多发生注意障碍,临床表现为对消症(extinction)和单侧空间忽视症(unilateral spatial neglect, USN),严重影响患者功能康复。自下而上的线索提示(bottom-up cues)可调节被试的注意功能,对脑损伤忽视症症状影响的研究较少。本研究采用两种自下而上的线索提示,研究其对患者的症状改善作用,并探讨其可能的康复价值。研究一、通过给视觉对消症患者添加患侧听觉线索提示(auditory cue),探究听觉通道线索对视觉通道症状的改善作用。研究二、通过控制视觉物体的连通性,研究视知觉组织线索提示(perceptual grouping cue)对忽视症症状的改善效应。 方法研究一:ABA设计方法,给10例对消症患者添加听觉线索提示,采用视觉双同时刺激(double simultaneous stimulation, DSS)报告正确率为对消指标,比较基线期(A1期)、干预期(B期)、撤去干预期(A2期)患者的DSS正确率,探究听觉通道线索对视觉通道对消症状的改善作用。研究二:11例忽视症患者,采用临摹画花实验,,遗漏的花瓣及叶子的数目作为忽视症症状指标,通过计算在两朵花分开、两朵花通过直线连通、两朵花通过曲线连通,两朵花伪连通四种连通条件下花叶遗漏数,研究连通性的改变对忽视症状的改善作用。 结果研究一:干预期比基线期DSS正确率提高(A1-B,T=-2.803, P0.01);撤去干预DSS正确率降低(B-A2,T=-2.613, P0.01; A2-A1,T=-1.897, P0.05)。研究二:11例忽视症症状表现明显,两花分开的情况下花叶遗漏数为(14.7±2.5),忽视症状明显。与其比较,直线连通(遗漏数为8.6±5.0, T=-2.943, P0.01)以及曲线连通条件下(遗漏总数为8.4±4.7, T=-2.807, P0.01)可使忽视症症状得到显著改善。与无连通相比,伪连通的条件下(遗漏总数为13.6±3.2,T=-0.134, P=0.894)忽视症症状无改善。 结论研究一:本研究表明听觉线索提示可以改善视觉对消症状,跨通道感觉间存在着相互作用,听觉通道线索可用于促进视觉对消的症状康复。研究二:研究表明物体的连通性对加工有调节作用,结果表明在两物体间添加连通线条可以改善忽视症症状,提示知觉组织线索提示对忽视症有康复意义。研究一和研究二为通过线索提示对注意损伤为主的脑损伤的康复应用提供了实验依据和基础。
[Abstract]:Objective the patients with brain injury may be left with many cognitive disorders, and the patients with right cerebral apoplexy often have attention disorders. The clinical manifestations are (extinction) and (unilateral spatial neglect, USN), which seriously affect the functional rehabilitation of patients with unilateral spatial neglect. Bottom-up cues (bottom-up cues) can regulate the attention function of the subjects, and there are few studies on the effects of brain injury neglect symptoms. In this study, two bottom-up cues were used to study the improvement of symptoms and the possible value of rehabilitation. In the first study, (auditory cue), was added to the patients with visual cancellation to explore the effect of auditory channel cues on the improvement of visual channel symptoms. Second, by controlling the connectivity of visual objects, the study of visual perceptual tissue cues suggests the effect of (perceptual grouping cue) on the improvement of the symptoms of neglect. Methods ABA design method was used to add auditory cues to 10 patients with cancellative disease. The correct rate of (double simultaneous stimulation, DSS) report was compared with baseline period (phase A1) and dry expectation (stage B). To explore the effect of auditory channel cues on the improvement of visual channel symptoms in patients with stage A 2 by removing the correct rate of DSS. Study II: 11 patients with neglect were studied by copying the number of petals and leaves as indicators of the symptoms of neglect. By calculating that the two flowers were separated, two flowers were connected in a straight line, two flowers were connected through a curve, two flowers were connected by a straight line, and two flowers were connected by a curve. To study the effect of the change of connectivity on the improvement of neglect symptoms, the number of leaf omissions was studied under four conditions of pseudo-connectivity of two flowers. Results in the first study, the accuracy rate of DSS in dry expectation was higher than that in baseline (A _ 1-B _ (1) T _ (-2.803), P0.01), and the correct rate of DSS was decreased after withdrawal (B-A _ 2 / T _ (2.613), P ~ (0.01); A _ 2-A _ (1) T _ (-1.897), P 0.05). In the second study, the symptom of neglect was obvious in 11 cases. The number of omissions was (14.7 卤2.5) and the symptom of neglect was obvious when the two flowers were separated. In comparison, linear connectivity (8.6 卤5.0) and curve connectivity (8.4 卤4.7, TG-2.807, P0.01) could significantly improve the symptom of neglect in the condition of curve connectivity (8.6-2.943, P0.01) and curve connectivity (8.4 卤4.7, TG-2.807, P0.01). There was no improvement in the symptom of neglect in the condition of pseudo-connectivity (the total number of omissions was 13.6 卤3.2T ~ (-0.134), P _ (0.94) compared with that without connectivity. Conclusion: this study shows that auditory cues can improve the symptoms of visual cancellation and cross-channel sensory interaction. Auditory cues can be used to promote the recovery of visual cancellation symptoms. Study 2: the study shows that the connectivity of objects can regulate the processing. The results show that adding the connected lines between the two objects can improve the symptoms of neglect, suggesting that perceptual tissue cues have rehabilitation significance for neglect. The first and second studies provide experimental basis and basis for the rehabilitation of brain injury mainly caused by attentional injury through cues.
【学位授予单位】:安徽医科大学
【学位级别】:硕士
【学位授予年份】:2014
【分类号】:R743.3

【参考文献】

相关期刊论文 前2条

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2 韩世辉,G.W.Humphreys,李清阳;注意与非注意位置的知觉组织[J];中国科学(C辑:生命科学);2004年05期



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