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신경정신학에 융복합되는 신경생물학적 접근법의 한계점: 발달성 협응장애와 두 시각 이론에 관한 종설

Limitations of neurobiological approach convergent to neuropsychiatry: DCD and two visual systems theory

  • 투고 : 2015.04.04
  • 심사 : 2015.06.20
  • 발행 : 2015.06.28

초록

신경생물학 접근법은 정신학에서의 심신 이원론 문제를 해결하고 새로운 진단과 치료법을 발달시키는 데 도움을 주었다. 하지만 신경정신장애의 복합성 때문에 신경생물학의 신경해부학 부분을 너무 강조하는 것은 문제가 될 수 있다. 예를 들어, 발달성 협응장애 (DCD)는 일반적으로 움직임과 관련된 장애이지만 종종 지각과도 긴밀한 관계가 있다. 뇌의 기능적 분류에 입각한 두 시각 이론은 대뇌의 복측은 물체의 재인을, 배측은 움직임, 위치와 관련되어 있다고 주장한다. 하지만 물체의 지각은 시각적으로 유도되는 행동과 밀접한 관련이 있다. 이 논문에서는 두 시각 이론을 설명하는 기본적인 연구들을 검토하고, 이 이론에 대한 비판을 제시한다. 특히, 발달성 협응장애와 같은 운동뿐만 아니라 지각과 관련이 있는 신경정신장애에 구조적인 신경생물학 접근법을 적용하는 것의 한계점을 제시한다. 결론적으로, 현대의 신경정신분야에 융복합적으로 사용되는 신경생물학 접근법은 유용하지만, 신경구조적 분류에 너무 집중하면 한계점이 나타날 수 있다.

Neurobiological approach helps to resolve the mind-body dualism and develop new assessment and treatment approaches in psychiatry. However, it could be a problem to place too much emphasis on certain aspects of neurobiology, specifically structural neuroanatomy, because of the complexity or comorbidity of neuropsychiatric disorders. Developmental Coordination Disorder (DCD), for instance, is generally related to problems in motor skills and this movement disability is often related to perception. One account, two visual systems theory, relied on functional distinction in brain; ventral stream is responsible for visual recognition, and dorsal stream is responsible for the guidance of actions. However, Studies are now showing that shape perception is relevant to visually guided action, such as reaching-to-grasp an object. In this article, I reviewed fundamental findings of two-visual system theory and suggested problems of visually guided action to consider what shape perception implies for the two visual systems. Questions raised highlight possible limitations of adopting a structural neuroanatomical approach to account for perception and action effects, and by extent related psychiatric conditions such as DCD. In conclusion, neurobiological approach converging to neuropsychiatry, while useful, would be limited if it focuses too much on anatomical distinction.

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