Superior parietal cortex has been implicated in visuomotor guidance and is proposed to be specialised for action in the lower visual field and peripersonal space. Two patients, one with a right superior parietal lesion leading to optic ataxia (ME), and one with a lesion affecting right inferior parietal cortex (LH), were compared to elderly controls (n=8) and young controls (n=8) on a reciprocal pointing task with movements made in the near-far direction (i.e., sagittal plane) or right-left direction (i.e., fronto-parallel plane). In contrast to both control groups, who demonstrated a speed-accuracy trade-off in movement time and peak velocity, neither of the patients did. When the time spent post-peak velocity (represented as a percentage of total movement time) was examined, both patients demonstrated larger times post-peak velocity than controls for all movement directions. Furthermore, while rightward movements of the right hand had higher times post-peak velocity than leftward movements there were no directional patterns for near-far movements which contrasted with controls who had larger times post-peak velocity for near movements. The patient with the more superior lesion (ME) had the greatest difficulty with movements made back toward the body suggestive of a role for superior parietal cortex in the fine tuning of movements made in this region of space (i.e., personal or peripersonal space). In contrast, all directions of movement seemed to be equally affected in the patient with a more inferior lesion. These results are discussed in terms of the different roles played by inferior and superior parietal cortex in the control of visually guided movements.

Superior parietal cortex has been implicated in visuomotor guidance and is proposed to be specialised for action in the lower visual field and peripersonal space. Two patients, one with a right superior parietal lesion leading to optic ataxia (ME), and one with a lesion affecting right inferior parietal cortex (LH), were compared to elderly controls (n=8) and young controls (n=8) on a reciprocal pointing task with movements made in the near-far direction (i.e., sagittal plane) or right-left direction (i.e., fronto-parallel plane). In contrast to both control groups, who demonstrated a speed-accuracy trade-off in movement time and peak velocity, neither of the patients did. When the time spent post-peak velocity (represented as a percentage of total movement time) was examined, both patients demonstrated larger times post-peak velocity than controls for all movement directions. Furthermore, while rightward movements of the right hand had higher times post-peak velocity than leftward movements there were no directional patterns for near-far movements which contrasted with controls who had larger times post-peak velocity for near movements. The patient with the more superior lesion (ME) had the greatest difficulty with movements made back toward the body suggestive of a role for superior parietal cortex in the fine tuning of movements made in this region of space (i.e., personal or peripersonal space). In contrast, all directions of movement seemed to be equally affected in the patient with a more inferior lesion. These results are discussed in terms of the different roles played by inferior and superior parietal cortex in the control of visually guided movements.

Some authors have argued that the primary function of the posterior parietal cortex is to control visual attention and awareness, whereas others have argued that the posterior parietal cortex is specialized for controlling actions. The purpose of the present thesis was to examine the influence of prism adaptation – a visuomotor adaptation technique – on visual attention deficits in patients with lesions of parietal cortex. Lesions to dorsal regions of the posterior parietal cortex lead to optic ataxia – a disorder in which visually guided reaching is disrupted. In contrast lesions to ventral (i.e. inferior) regions of the posterior parietal cortex of the right hemisphere lead to spatial neglect – a disorder in which patients are unaware of people or objects in contralesional (left) space. Chapter 1 presents an overview of the organization of the posterior parietal cortex, as well as an introduction to the disorders of spatial neglect and optic ataxia and the use of prism adaptation as a treatment for spatial neglect. Chapter 2 examined the influence of prism adaptation on attentional deficits in patients with right brain damage. Results demonstrated that prism adaptation reduced both the disengage deficit and the rightward attentional bias, two of the classic attentional deficits in neglect. Chapter 3 investigated the role of the dorsal posterior parietal cortex in controlling both reflexive and voluntary attention in two patients with optic ataxia. Lesions to the dorsal posterior parietal cortex led to both a disengage deficit and a rightward attentional bias, similar to patients with neglect, even though neither of the patients had any clinical symptoms of neglect. Contrary to previous work these results indicated that dorsal portions of the posterior parietal cortex – a region not commonly damaged in neglect – are important for controlling the orienting and reorienting of both reflexive and voluntary attention. Furthermore, these results indicated that optic ataxia is not purely a visuomotor disorder that is independent of any perceptual or attentional deficits as was previously assumed. Based on the results of Chapters 2 and 3 it was hypothesized that the beneficial effects of prism adaptation on attention may operate via the superior parietal lobe, a region which is typically undamaged in neglect, and is known to be important for controlling attention and action. Chapter 4 provided support for this hypothesis by demonstrating that a patient with lesions to the superior parietal lobe, who had the same attentional deficits as the right brain damaged patients tested in Chapter 2, failed to demonstrate any beneficial effects of prism adaptation on his attentional performance. Specifically, prism adaptation had no influence on his disengage deficit or his rightward attentional bias. Therefore, these data provide direct evidence that the beneficial effects of prisms on attention rely, at least in part, on the superior parietal lobe. Finally, Chapter 5 concludes with a summary of the research findings from the present thesis, and puts forward a new theory to conceptualize the mechanisms underlying the beneficial effects of prisms in patients with neglect.

Some authors have argued that the primary function of the posterior parietal cortex is to control visual attention and awareness, whereas others have argued that the posterior parietal cortex is specialized for controlling actions. The purpose of the present thesis was to examine the influence of prism adaptation – a visuomotor adaptation technique – on visual attention deficits in patients with lesions of parietal cortex. Lesions to dorsal regions of the posterior parietal cortex lead to optic ataxia – a disorder in which visually guided reaching is disrupted. In contrast lesions to ventral (i.e. inferior) regions of the posterior parietal cortex of the right hemisphere lead to spatial neglect – a disorder in which patients are unaware of people or objects in contralesional (left) space. Chapter 1 presents an overview of the organization of the posterior parietal cortex, as well as an introduction to the disorders of spatial neglect and optic ataxia and the use of prism adaptation as a treatment for spatial neglect. Chapter 2 examined the influence of prism adaptation on attentional deficits in patients with right brain damage. Results demonstrated that prism adaptation reduced both the disengage deficit and the rightward attentional bias, two of the classic attentional deficits in neglect. Chapter 3 investigated the role of the dorsal posterior parietal cortex in controlling both reflexive and voluntary attention in two patients with optic ataxia. Lesions to the dorsal posterior parietal cortex led to both a disengage deficit and a rightward attentional bias, similar to patients with neglect, even though neither of the patients had any clinical symptoms of neglect. Contrary to previous work these results indicated that dorsal portions of the posterior parietal cortex – a region not commonly damaged in neglect – are important for controlling the orienting and reorienting of both reflexive and voluntary attention. Furthermore, these results indicated that optic ataxia is not purely a visuomotor disorder that is independent of any perceptual or attentional deficits as was previously assumed. Based on the results of Chapters 2 and 3 it was hypothesized that the beneficial effects of prism adaptation on attention may operate via the superior parietal lobe, a region which is typically undamaged in neglect, and is known to be important for controlling attention and action. Chapter 4 provided support for this hypothesis by demonstrating that a patient with lesions to the superior parietal lobe, who had the same attentional deficits as the right brain damaged patients tested in Chapter 2, failed to demonstrate any beneficial effects of prism adaptation on his attentional performance. Specifically, prism adaptation had no influence on his disengage deficit or his rightward attentional bias. Therefore, these data provide direct evidence that the beneficial effects of prisms on attention rely, at least in part, on the superior parietal lobe. Finally, Chapter 5 concludes with a summary of the research findings from the present thesis, and puts forward a new theory to conceptualize the mechanisms underlying the beneficial effects of prisms in patients with neglect.

京都大学 / 0048 / 新制・論文博士 / 博士(医学) / 乙第12817号 / 論医博第2079号 / 新制||医||1004(附属図書館) / 31304 / 京都大学大学院医学研究科脳統御医科学系専攻 / (主査)教授 河野 憲二, 教授 金子 武嗣, 教授 大森 治紀 / 学位規則第4条第2項該当 / Doctor of Medical Science / Kyoto University / DFAM

Afin d’effectuer un mouvement de la main, le système nerveux doit mettre en commun des informations issues de plusieurs sens : c’est l’intégration multisensorielle. Le cortex pariétal postérieur est une interface sensorimotrice qui est impliquée dans le processus d’intégration multisensorielle. Si cette région est endommagée, les patients présentent un trouble visuomoteur dénommé ataxie optique qui se caractérise par une difficulté à réaliser des mouvements visuellement guidés de la main. À ce jour, les mécanismes qui sous-tendent l’intégration multisensorielle pour l’action ne sont pas encore totalement connus. Le premier axe de ma thèse consiste à définir, chez les sujets sains, comment les informations visuelles et somatosensorielles sont intégrées pendant la planification d’un mouvement de pointage. Le deuxième axe s’intéresse aux troubles sensorimoteurs associés à l’ataxie optique qui permettent une meilleure compréhension des fonctions du cortex pariétal postérieur dans la planification motrice et le contrôle du mouvement. / To execute reach movements, the central nervous system needs to combine informationfrom different sensory modalities, a process knows as multisensory integration. Theposterior parietal cortex is a sensorimotor interface implicated in multisensory integrationprocesses. Patients with a damage to this region exhibit a visuomotor deficit called opticataxia. Patients with optic ataxia present difficulties in performing hand visually-guidedmovements. To date, the mechanisms underlying multisensory integration are still notfully understood. The first aime of my thesis is to determine how visual and somatosensoryinformation are integrated in healthy participants, during the planning of pointingmovements. I will then focus on the sensorimotor deficits observed in optic ataxia whichenable a better understanding of the functions of the posterior parietal cortex in motorplanning and online control.

No description available.

Bien que l’inhibition soit souvent considérée comme un concept uniforme, les habiletés d’inhibition se divisent en plusieurs types : l’inhibition spatiale et l’inhibition de réponse. L’inhibition spatiale réfère à l’atténuation de l’interférence de localisations contenant des stimuli saillants et non pertinents. Par exemple, l’inhibition spatiale guide la recherche visuelle de sorte à limiter la visite répétée de localisations déjà explorées. À l’opposé, l’inhibition de réponse est un processus de type moteur et permet l’adaptation du comportement à un contexte changeant lorsqu’un mouvement doit être altéré ou arrêté. Bien qu’il soit admis que les habiletés d’inhibition se subdivisent en plusieurs types, tel que l’inhibition spatiale et l’inhibition de réponse, les différents mécanismes les sous-tendant demeurent mal compris et sous explorés. L’objectif principal de la présente thèse était d’explorer les mécanismes communs et différents de l’inhibition spatiale et l’inhibition de réponse. Particulièrement, les mécanismes de suppression et de facilitation lors de la sélection de la cible furent décrits pour l’inhibition spatiale. De même, la perturbation des habiletés de l’inhibition spatiale et la préservation relative des habiletés d’inhibition de réponse à la suite à de lésions du cortex pariétal postérieur dorsal furent exemplifiées. Finalement, les apports spécifiques du cortex pariétal postérieur dorsal pour l’inhibition spatiale et l’inhibition de réponse furent définis. / While inhibition is often considered a uniform concept, inhibition abilities can be divided in many types: spatial inhibition and response inhibition. Spatial inhibition refers to the attenuation of the interference from locations containing salient and non-pertinent stimuli. For example, spatial inhibition guides visual search to limit the repeated visit of already explored locations. In contrast, response inhibition is motor-based and allows the adaptability of behaviour in a changing context when a movement must be prevented or altered. Although it is widely accepted that inhibition abilities can be divided in many types, such as spatial or response inhibition, the different mechanisms underlying them remain poorly understood and under-explored. The main aim of the present thesis was to explore the common and different mechanisms of spatial and response inhibition. Precisely, the mechanisms of suppression and enhancement during target selection were described during spatial inhibition. The alteration of spatial inhibition processes and the relative preservation of response inhibition abilities in patients with dorsal posterior parietal cortex lesions were also underlined. Finally, the specific contributions of the dorsal posterior parietal cortex for spatial and response inhibition were defined.