BRAIN and NERVE－神経研究の進歩64巻7号

2012年07月発行

増大特集 顔認知の脳内機構

神経内科疾患と顔認知

著者： 河村満¹ 杉本あずさ¹ 小早川睦貴¹ 鶴谷奈津子¹

所属機関： ¹昭和大学医学部内科学講座神経内科学部門

ページ範囲：P.799 - P.813

文献概要

はじめに

　本稿では，さまざまな神経疾患における顔認知障害について述べる。

　脳梗塞では，時に相貌失認が生じることが古くから知られていたが，その責任病巣については長く議論があり，ようやく最近になって右紡錘状回病変が重要であることがわかってきた。

　相貌失認典型例では普通表情認知は保たれる。一方で，パーキンソン病（Parkinson disease：PD）では表情認知障害（表情失認）が生じ，扁桃体病変との関与が疑われる。PD関連病態であるとされる，レム期睡眠行動異常症（REM sleep behavioral disorder：RBD）でも表情失認は明らかであり，表情失認はPDの初期あるいは病前症候として重要である。筋強直性ジストロフィーにも表情認知の障害がある。中核症状である筋病変とともに古くから知られている「独特の性格変化」の背景には，表情失認をはじめとした社会的認知障害の存在が疑われる。

　顔認知研究は学際的になされているが，神経内科領域でも重要で，その意義について疾患別に述べたいと思う。

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