Anosognosia after stroke: assessment, occurrence, subtypes and impact on functional outcome reviewed

Jehkonen, Mervi; Laihosalo, Mari; Kettunen, Jani E

doi:10.1111/j.1600-0404.2006.00723.x

Cited by 104 publications

(103 citation statements)

References 69 publications

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“…Cocchini, Beschin, Cameron, Fotopoulou, & Della Sala, 2009 for left hemisphere cases; Jehkonen, Laihosalo, & Kettunen, 2006), recent neuroimaging studies have not identified a consistent pattern of brain lesion or dysfunction selectively associated with AHP. Specifically, some studies have highlighted the potential role of cortical areas such as the right insula in AHP (Berti et al, 2005;Fotopoulou et al, 2010; Baier, & Nägele, 2005;Vocat et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

Motor versus body awareness: Voxel-based lesion analysis in anosognosia for hemiplegia and somatoparaphrenia following right hemisphere stroke

Moro

Pernigo

Tsakiris

et al. 2016

Cortex

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Anosognosia for hemiplegia (AHP) is informative about the neurocognitive basis of motor awareness. However, it is frequently associated with concomitant symptoms, such as hemispatial neglect and disturbances in the sense of body ownership (DSO). Although double dissociations between these symptoms have been reported, there is ongoing debate about whether they are manifestations of independent abnormalities, or a single neurocognitive deficit.We aimed to investigate the specificity of lesions associated with AHP by surpassing four, existing methodological limitations: (a) recruit a relatively large sample of patients (total N = 70) in a multi-centre study; (b) identify lesions associated with AHP in grey and white matter using voxel-based methods; (c) take into account the duration of AHP and concomitant neglect symptoms; and (d) compare lesions against a control hemiplegic group , patients suffering from AHP and DSO, and a few, rare patients with selective DSO. Results indicated that acute AHP is associated with a wide network, mainly including: (1) the Rolandic operculum, (2) the insula and (3) the superior temporal gyri. Subcortically, damage mainly involved the basal ganglia and white matter, mostly the superior corona radiate, arcuate fasciculus and the ventral part of the superior longitudinal fasciculus. Persistent symptoms were linked with wider damage involving fronto-temporal cortex and long white matter tracts. A shift in the latero-medial direction (mainly involving the basal ganglia and surrounding white matter) emerged when DSO was taken accounted for. These results suggest that while bodily awareness is processed by areas widely distributed across the brain, intact subcortical structures and white matter tracts may be necessary to support basic feelings of owning and controlling contralateral body parts. An accurate and 'up-to-date' awareness of our motor abilities, however, may rely also on intact processing in cortical areas which presumably allow higher-order inferences about the current state of the body. Reviewer #1: The authors investigated the neuronal basis for anosognosia (AHP) and related disorders (body awareness and spatial neglect). The authors report a 70-strong study cohort, which they separate into different groups for their analysis and claim a different neuronal pattern for the acute and chronic stages of anosognosia. Whilst this study is well-written and strong neuropsychologically, the imaging analysis and in particular its interpretation lack substance. The anatomical regions described most the time do not match with the figures provided and therefore the conclusion of the current manuscript are not supported by the neuroimaging findings. The authors need to work on this aspect before publication should be considered. Motor Versus Body General comments1. The introduction is very well written and leads nicely to the research hypotheses. However, given the limited publications available on the neuronal basis of anosognosia the authors should make an effort to include a ...

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Section: Introductionmentioning

confidence: 99%

Motor versus body awareness: Voxel-based lesion analysis in anosognosia for hemiplegia and somatoparaphrenia following right hemisphere stroke

Moro

Pernigo

Tsakiris

et al. 2016

Cortex

View full text Add to dashboard Cite

show abstract

“…Horizontal line indicates the cut-off score of 7 (Crawford et al, 2006) 2010). Lack of consensus amongst researchers and clinicians about the methods of assessment results in difficulties in comparing findings across different studies (Vuilleumier, 2000;2004;Adair et al, 2003;Baier & Karnath, 2005;Jehkonen et al, 2006;Vallar & Ronchi, 2006;Orfei et al, 2007;Jenkinson et al, 2011), and it may have produced contrasting findings (Cocchini & Della Sala, 2010). It seems indeed likely that while similar mechanisms may underlie anosognosia for different deficits, different causes may determine anosognosia for a specific deficit.…”

Section: Resultsmentioning

confidence: 99%

“…This is what we will refer to as "explicit anosognosia". The most common diagnostic tools are structured interviews and self-evaluation questionnaires (e.g., Jehkonen et al, 2006;Orfei et al, 2007Orfei et al, , 2010a; also summarised in Table 1). …”

Section: Methods To Assess Anosognosia For Motor Impairmentmentioning

confidence: 99%

“…The reported frequency of anosognosia following brain damage varies considerably across studies, ranging from 7% to 77% (Orfei et al, 2007; see also Jehkonen et al, 2006). This variability may be due to different diagnostic criteria (Baier & Karnath, 2005) or to recruitment of patients at different post-onset intervals.…”

Section: Anosognosia For Motor Impairmentsmentioning

confidence: 99%

“…However, reviews of the literature have shown that chronic anosognosia is not as rare as textbooks suggest (see Table 1 in Cocchini et al, 2002;Orfei et al, 2007;Jehkonen et al, 2006), and several studies have pointed out how lack of awareness can seriously interfere with functional recovery and rehabilitation training (Gialanella & Mattioli, 1992;Maeshima et al, 1997;Hartman-Maeir et al, 2001;Hartman-Maeir et al, 2002;Appelros et al, 2002;Gialanella, et al, 2005;Di Legge et al, 2005).…”

Section: Anosognosia For Motor Impairmentsmentioning

confidence: 99%

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