小脑损伤患者28例注意网络功能受损的特点

Injured attention networks in patients with cerebellum lesion：28 cases report

目的研究小脑损伤患者注意网络功能受损的特点。方法应用注意网络测验，对28例小脑损伤患者和31名健康对照进行注意网络功能的测试。结果与对照组相比，小脑损伤患者定向效率减低[病例组、对照组分别为（36．32±30．58）、（54．39±22．17）ms]，差异有统计学意义（Z=-2．309，P〈0．05）；执行控制受到损害[（160．05±83．25）、（93．42±37．41）ms]，差异有统计学意义（Z=-3．500，P〈0．01）；警觉效率[（35．14±45．59）、（28．81±26．09）ms]与总平均反应时[（797．14±94．11）、（739．90±97．90）ms]的差异无统计学意义。病例组的总平均错误率（6．57％±9．84％）明显高于对照组（3．38％±5．42％，Z=-2．119，P〈0．05）。结论小脑参与了注意网络的认知功能；小脑病变可选择性损害注意网络的定向和执行控制功能，而警觉功能相对保持正常。

Objective To investigate the characteristics of attention networks impairment in patients with lesion in the cerebellum. Methods The attention network test was used to compare patients with lesion in the cerebellum （n =28 ） with normal controls （n = 31 ） on the efficiency of three anatomically defined attention networks： alerting, orienting, and executive control. Results The orienting network effect was significantly worse （Z = - 2. 309, P 〈 0. 05 ） in patients with lesion in the cerebellum （ （36. 32 ± 30. 58 ） ms） than in normal controls （ （54. 39 ±22. 17） ms）. The executive control network in patients （ （160. 05 ± 83.25） ms） with lesion in the cerebellum was worse than those of controls （ （93.42 ± 37. 41 ） ms, Z = -3. 500, P〈0. 01）. The alerting networks effects was higher in patients （ （35.14 ±45.59） ms） than in normal controls （ （28.81 ± 26. 09 ） ms）, without significant difference. The average reaction time was longer in patients than in normal controls, but there was no significant difference. The wrong rate of attention network test was significantly higher （Z = -2. 119, P 〈0.05 ） in patients （6. 57% ±9. 84% ） than in normal controls （3.38% ± 5.42% ）. Conclusion The patients with lesion in the cerebellum may be selectively impaired of the orienting and executive networks, while the alering network is spared.