线等分试验与忽视症、偏盲的研究

Study on correlations of the line bisection test with neglect and hemianopia

目的了解中国老年人、忽视症、忽视症伴偏盲、单纯偏盲患者线等分试验的表现,探讨线等分试验对忽视症与偏盲的诊断价值及其神经心理学机制。方法对30例身体健康的中国老年人(正常对照组)以及73例单侧脑损伤患者(试验组)进行线等分试验检查,同时对73例单侧脑损伤患者进行忽视、偏盲检查。结果据忽视、偏盲检查结果将试验组分为单纯忽视症组、忽视症伴偏盲组和单纯偏盲组进行分析。正常对照组线等分试验无论左手、右手皆左向偏移,且左手偏移明显,两者相比差异有显著性(P<0.001)。单纯忽视症组线等分试验多半偏向脑损伤的同侧,与正常对照组相比差异有显著性(P<0.001);忽视症伴偏盲组与单纯忽视症组线等分试验都偏向脑损伤的同侧,且前者偏移明显,两者相比差异有显著性(P<0.001);单纯偏盲组线等分试验偏向脑损伤的对侧,与正常对照组相比差异有显著性(P<0.05)。结论线等分试验存在左、右手侧别的差别,线等分试验是忽视症较好的检查方法之一,线等分试验不完全和其它忽视症试验相关联,偏盲加重水平线索忽视程度,偏盲不影响线等分试验对忽视症的检测率。线等分试验可用来鉴别单纯偏盲和忽视。

Objective To investigate clinical performance of the line bisection test for subjects including the Chinese elderly, patients who have neglect with or without hemianopia, and patients with pure hemianopia, and to explore the diagnostic value of the test on neglect and hemianopia, and its neuropsychological mechanisms. Methods Both the 30 healthy Chinese elderly cases （normal control group） and 73 cases with unilateral cerebral damage （experimental group） underwent the line bisection test; the latter 73 cases also underwent examinations to determine whether they had neglect or hemianopia. Results According to the results of neglect and hemianopia examinations, the experimental group was divided into pure neglect, neglect with hemianopia, and pure hemianopia subgroups, and further analyzed. Whether to use the left or right hand, the line bisection test of the normal control group indicated leftward deviation and the deviation by the left hand was more obvious; the comparison between the two hands was significant （P〈0.001）. The line bisection test of the pure neglect subgroup indicated deviation mostly to the ipsilateral of cerebral damage and its comparison with the normal control group was significant （P〈0.001）; the line bisection test for neglect accompanied by hemianopia and pure hemianopia subgroups indicated deviation to the ipsilateral of cerebral damage and deviation by the former was more obvious, so the comparison between the two subgroups was significant （P〈0.001）; the line bisection test of the pure hemianopia subgroup showed deviation to the contralateral of cerebral damage, and its comparison with the normal control group was significant （P〈0.05）. Conclusion The performance of the line bisection test differs between the left and right hands, so it is one of the best approaches for the diagnosis of neglect. The line bisection test is not entirely correlated with other diagnostic tests of neglect; hemianopia may aggravate the degree of neglect of horizontal clues, but does not affect the detection rate of the line bisection test for neglect diagnosis. Briefly, the line bisection test is a beneficial tool of distinguishing neglect from pure hemianopia.