【摘要】：目的腦損傷患者會遺留多種認(rèn)知功能障礙，右側(cè)腦卒中患者多發(fā)生注意障礙，臨床表現(xiàn)為對消癥（extinction）和單側(cè)空間忽視癥（unilateral spatial neglect, USN），嚴(yán)重影響患者功能康復(fù)。自下而上的線索提示（bottom-up cues）可調(diào)節(jié)被試的注意功能，對腦損傷忽視癥癥狀影響的研究較少。本研究采用兩種自下而上的線索提示，研究其對患者的癥狀改善作用，并探討其可能的康復(fù)價(jià)值。研究一、通過給視覺對消癥患者添加患側(cè)聽覺線索提示（auditory cue），探究聽覺通道線索對視覺通道癥狀的改善作用。研究二、通過控制視覺物體的連通性，研究視知覺組織線索提示(perceptual grouping cue)對忽視癥癥狀的改善效應(yīng)。 方法研究一：ABA設(shè)計(jì)方法，給10例對消癥患者添加聽覺線索提示，采用視覺雙同時刺激（double simultaneous stimulation, DSS）報(bào)告正確率為對消指標(biāo)，比較基線期（A1期）、干預(yù)期（B期）、撤去干預(yù)期（A2期）患者的DSS正確率，探究聽覺通道線索對視覺通道對消癥狀的改善作用。研究二：11例忽視癥患者，采用臨摹畫花實(shí)驗(yàn)，，遺漏的花瓣及葉子的數(shù)目作為忽視癥癥狀指標(biāo)，通過計(jì)算在兩朵花分開、兩朵花通過直線連通、兩朵花通過曲線連通，兩朵花偽連通四種連通條件下花葉遺漏數(shù)，研究連通性的改變對忽視癥狀的改善作用。 結(jié)果研究一：干預(yù)期比基線期DSS正確率提高（A1-B，T=-2.803, P0.01）；撤去干預(yù)DSS正確率降低（B-A2，T=-2.613, P0.01； A2-A1，T=-1.897, P0.05）。研究二：11例忽視癥癥狀表現(xiàn)明顯，兩花分開的情況下花葉遺漏數(shù)為(14.7±2.5)，忽視癥狀明顯。與其比較，直線連通(遺漏數(shù)為8.6±5.0, T=-2.943, P0.01)以及曲線連通條件下(遺漏總數(shù)為8.4±4.7, T=-2.807, P0.01)可使忽視癥癥狀得到顯著改善。與無連通相比，偽連通的條件下(遺漏總數(shù)為13.6±3.2，T=-0.134, P=0.894）忽視癥癥狀無改善。 結(jié)論研究一：本研究表明聽覺線索提示可以改善視覺對消癥狀，跨通道感覺間存在著相互作用，聽覺通道線索可用于促進(jìn)視覺對消的癥狀康復(fù)。研究二：研究表明物體的連通性對加工有調(diào)節(jié)作用，結(jié)果表明在兩物體間添加連通線條可以改善忽視癥癥狀,提示知覺組織線索提示對忽視癥有康復(fù)意義。研究一和研究二為通過線索提示對注意損傷為主的腦損傷的康復(fù)應(yīng)用提供了實(shí)驗(yàn)依據(jù)和基礎(chǔ)。
[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 鹵2.5) and the symptom of neglect was obvious when the two flowers were separated. In comparison, linear connectivity (8.6 鹵5.0) and curve connectivity (8.4 鹵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 鹵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 鹵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.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R743.3

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相關(guān)期刊論文 前2條

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