臨床神経学

第50回日本神経学会総会

<教育講演7>
高次脳機能障害と意識

鈴木 匡子

山形大学大学院医学系研究科高次脳機能障害学〔〒990-9585 山形市飯田西2-2-2〕

Conscious awareness is the state in which external and internal stimuli are perceived and can be intentionally acted on. Although various investigations have provided new insights into the neural mechanisms of conscious awareness, its whole network in human remains to be solved. Anosognosia for visual dysfunction and unconscious processing of visual stimuli are good examples of dissociation between cognitive processes and conscious awareness.
Anton syndrome, anosognosia for blind or deaf, could be observed in blindness caused by cerebral as well as ophthalmological diseases, when general cognitive function or attention is impaired. Unawareness of hemianopia is not an exception but a common phenomenon, which seems to be related to a completion phenomenon and macular sparing. Patients with visual agnosia are not consciously aware of the nature of their visual dysfunction but have a vague feeling of visual impairment.
Blindsight, unconscious visual processing in the blind field, might be partly related to the dorso-dorsal visual stream that takes roles in the control of actions "on line" without awareness of spatial perception. In patients with unilateral spatial neglect, unconscious processing of visual stimuli on the neglected space was also observed.
Better understanding of neural mechanisms of conscious awareness would provide insights into various neurological disorders and therapeutic approaches.
Full Text of this Article in Japanese PDF (279K)

(臨床神経, 49:794−796, 2009)
key words:高次脳機能, 意識, 病態失認, 意図

(受付日:2009年5月22日)