脑损伤病人结构性失用特征及机制研究

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	脑损伤病人结构性失用特征及机制研究
其他题名	Characteristics and mechanism of constructional apraxia of patients with brain lesions
	崔伟
	2014-05
摘要	结构性失用是指“病人在结构性、构成性行为（如排列、建筑、绘画等）中因任务的空间成分缺失而出现的困难”。以往对结构性失用的研究，大多遵循临床—解剖的研究方法，研究结果存在很多不一致，对视空间结构功能认知过程障碍的研究较少，缺乏结构性失用在文字材料的考察。本研究采用传统结构性失用神经心理检测和认知神经心理学研究手段相结合的方法，以正常人为对照组，对脑损伤病人完成二维结构任务（包括汉字书写任务）的表现、各种结构测验的特征（包括效度、区分度和难度）及脑损伤病人的表象能力（空间认知功能的核心）进行探索。传统神经心理检测主要包括简单平面图形临摹、Bender完型测验、Rey复杂图形临摹、简单立体图形临摹、画钟测验、画房测验、火柴搭建、Kohs立方体组合测验，汉字书写任务采用汉字抄写测验；表象加工任务采用两可图形识别任务、表象旋转和表象组合任务。主要结果如下： 1．脑损伤病人完成所有二维结构任务均存在困难； 2．图形的复杂性和任务的性质会影响脑损伤被试的完成情况； 3．Rey复杂图形临摹任务、简单立体图形临摹任务和汉字抄写任务等三种二维结构任务是比较恰当的评估中国脑损伤病人结构能力的测验； 4．结构性失用与表象加工障碍密切相关； 5．结构性失用被试对图形空间信息加工的效率较低，注视模式也异于正常被试，且易被无关刺激吸引。综上所述，本研究采用传统神经心理测验与认知神经心理学相结合的手段考察了中国脑损伤病人的结构认知特征，提出了适合检测中国脑损伤病人结构能力的临床测验，明确了表象能力障碍与结构性失用的密切关系。
其他摘要	The neurologists coined the term “constructional apraxia” to describe "a disturbance in formative activities (arranging, building, and drawing)" in which the spatial part of the task is missed. Influenced by the localizationist associationist theoretical trend, the studies of constructional apraxia has generally been descriptive, and followed an anatomo-clinical approach in the past 100 years. However, this framework has not been successful in grasping the componential nature of the processing deficits underlying constructional apraxia. This study employed traditional neuropsychological tests and cognitive neuropsychological methods to research the characteristics and mechanisms of constructional apraxia caused by brain lesions in traditional two dimension constructional tests and Chinese character writing task. The traditional neuropsychological tests included simple 2D figure copy, Bender gestalt test, Rey complex figure copy, simple 3D figure copy, clock drawing test, house drawing test, stick building test, and Kohs block building test. The character writing test was Chinese character copying test. Ambiguous figure identification task, image mental rotation task, and image mental composite task were used to implore patients’ imaginary abilities. The main results are listed as followes: 1．The constructional apraxia which caused by brain lesions was reflected in all of the two dimension constructional tasks. 2．The degree of figure complexity and the features of the tasks were important factors which determined the success or failure in finishing the tasks. 3．Rey complex figure copy test, simple 3D figure copy and Chinese character copy test were sensitive and proper in evaluating the constructive abilities of brain lesions in China. 4．Constructional apraxia was closely related with impairment of imaginary ability. 5．The efficiencies of constructional apraxia subjects’ in processing spatial information are lower than normal subjects’, patients’ fixation patterns were abnormal, and they were easier to be attracted by irrelevant stimuli. The present study explored the charecteristics of patients’ constructive cognition with brain-lesions in China, proposed the tests which are suitable for Chinese in clinical, and identified the close relationship between constructional apraxia and disable in imaginary.
学科领域	医学心理学
关键词	视空间结构认知结构性失用二维结构任务表象加工
学位类型	博士
语种	中文
学位专业	心理学
学位授予单位	中国科学院研究生院
学位授予地点	北京
文献类型	学位论文
条目标识符	http://ir.psych.ac.cn/handle/311026/19499
专题	健康与遗传心理学研究室
作者单位	中国科学院心理研究所
推荐引用方式 GB/T 7714	崔伟. 脑损伤病人结构性失用特征及机制研究[D]. 北京. 中国科学院研究生院,2014.

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