認路障礙的行爲神經學觀

Topographical Disorientation: Viewpoints from Behavioral Neurology

10.29819/ANT.200812.0010

白明奇(Ming-Chyi Pai)

找路行爲 ； 認路 ； 地域失定向 ； 失智 ； 認知地圖 ； 海馬迴 ； 腦傷 ； Way finding ； Navigation ； Topographical disorientation ； Dementia ； Cognitive map ； Hippocampus

Acta Neurologica Taiwanica

17卷4期（2008 / 12 / 01）

267 - 274

繁體中文

找路的認知過程複雜，包含對陌生地的學習與熟悉地的確認、路徑整合，更與地標再認、空間記憶有關。一旦發現迷路，則要有好的解決問題的能力，否則會導致必須他人護送回家的後果。 從動物研究到臨床觀察、以及正常人的功能性影像研究得知，認路的過程確實與許多大腦的特定構造有關，尤其是右側後枕葉的舌狀腦迥、右側後頂葉、和帶迥後方腦區及右側副海馬迥，這些區域發生病變，可能導致地域失定向或認路障礙，阿茲海默氏症等失智症病人，更是認路障礙的最大族群。 本文將從塞礎到臨床，逐步探討人類認路的功能及其障礙。

To navigate freely and safely in familiar environments is essential for humans in everyday life. This ability, however, can be deprived of after a focal cerebral damage or degenerative disease, such as Alzheimer's disease. In this article, the author introduces the concept of way finding behavior from animals to humans, and its dysfunction or topographical disorientation (TD) in humans which develops after focal cerebral damage and dementing illnesses. The author also links the neuro-anatomical structures, the cognitive functions related to way finding and the clinical manifestations of TD, with an attempt to clarify the brain-behavioral relationship. For neurologists, the awareness of TD and its knowledge is helpful to make a correct diagnosis and to improve the quality of life of their patients.