Assessing anosognosias after stroke: A review of the methods used and developed over the past 35 years

Nurmi, Mari; Jehkonen, Mervi

doi:10.1016/j.cortex.2014.04.008

Cited by 32 publications

(18 citation statements)

References 84 publications

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“…No difference in age and education was found between the AD and the HC group for the neuropsychological assessment (Age (AD: 70.5 [ 8.75 ], HC ( n = 19): 65 [ 20 ], p = 0.38); level of education in years (AD: 12 [ 3.5 ], HC: 12 [ 4 ], p = 0.84) and between the AD group and the HC on imaging assessment (Age (AD: 70.5 [ 8.75 ], HC ( n = 16): 67.5 [ 6.25 ], p = 0.44) and level of education in years (AD: 12 [ 3.5 ], HC: 13.5 [ 6.5 ], p = 0.16). The anosognosia score was not related to the age and level of education in AD patients (see Supplementary Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

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Involvement of the Cingulate Cortex in Anosognosia: A Multimodal Neuroimaging Study in Alzheimer’s Disease Patients

Guerrier

Men

Gane

et al. 2018

JAD

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Background:Anosognosia is a frequent symptom of Alzheimer’s disease (AD), but its neural substrates remain in question.Objective:In this study, we combined neuroimaging with a neuropsychological evaluation to assess neural substrates of anosognosia.Methods:We prospectively recruited 30 patients with probable early-stage AD and matched healthy controls. Participants underwent MRI, FDG-PET, and a neuropsychological evaluation that includes an assessment of anosognosia. In the AD group, correlations between the anosognosia score, neuroimaging modalities, and neuropsychological performance were performed.Results:Atrophy and hypometabolism were correlated with the anosognosia score in the left dorsal anterior cingulate cortex. The anosognosia score was also correlated with atrophy of the cerebellar vermis, the left postcentral gyrus, and the right fusiform gyrus. No relation was found between anosognosia and the neuropsychological assessment.Discussion:Structural and metabolic alteration in the dorsal anterior cingulate cortex seems to be associated with a diminution of awareness in patients with early-stage AD.

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Section: Resultsmentioning

confidence: 99%

“…For several years, lack of awareness of cognitive deficits has been reported in dementia with high prevalence [ 1, 2 ], in psychiatric disorders [ 3 ] or following stroke [ 4 ]. Although some regions are commonly impacted in relation to the lack of awareness, it would seem that this phenomenon is pathology-dependent.…”

Section: Introductionmentioning

confidence: 99%

Involvement of the Cingulate Cortex in Anosognosia: A Multimodal Neuroimaging Study in Alzheimer’s Disease Patients

Guerrier

Men

Gane

et al. 2018

JAD

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“…In cognitive or behavioral rehabilitation settings, unawareness of deficits can lead individuals to set unrealistic activity goals and select maladaptive or inappropriate strategies [74]. Conversely, higher levels of self-awareness can enhance rehabilitation outcomes including independent daily functioning, social functioning, and safety adherence [75, 76]. Although not well known in research concerned with dementia, a link between self-awareness and poor rehabilitation and functional outcomes has been established in patients with stroke wherein those with right hemisphere lesions--often associated with self-awareness deficits-- are known to have worse outcomes as compared to those with left hemisphere lesions [77].…”

Section: Implications For Studying Self-awarenessmentioning

confidence: 99%

Integrating the Constructs of Anosognosia and Metacognition: a Review of Recent Findings in Dementia

Sunderaraman

Cosentino

2017

Curr Neurol Neurosci Rep

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The current review integrates recent findings regarding the construct of self-awareness in dementia from both clinical and cognitive perspectives. We present the predominant theoretical models of awareness, and summarize both traditional and emerging approaches to assessing awareness from clinical and metacognitive perspectives. In this review, we focus primarily on findings from recent studies in anosognosia and metacognition in the context of neurodegenerative disease with special emphasis on Alzheimer's disease and Frontotemporal dementia. Emerging trends in the study of awareness, including examination of the longitudinal course of anosognosia, and investigation of the neural substrates underlying metacognitive abilities are addressed. Finally, the practical importance of studying and assessing awareness from both theoretical and clinical angles is emphasized.

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“…Anosognosia refers to a lack of insight or awareness of impairments (e.g. hemiparesis, neglect, hemianopia) (Nurmi Laihosalo & Jehkonen, 2014). Estimates of the prevalence of neglect and anosognosia vary considerably.…”

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confidence: 99%

“…However, it has been estimated that 30-70% of stroke survivors with right hemisphere lesions have neglect and 20-60% of stroke survivors with left hemisphere lesions have neglect (Hreha et al, 2017). The vast majority of studies conducted with stroke survivors have focused on anosognosia of hemiparesis , which is estimated to affect ~30% of stroke survivors (Kortte & Hillis, 2009; Nurmi Laihosalo & Jehkonen, 2014). However, it is well recognized clinically that stroke survivors with neglect often have limited insight to their neglect and how neglect affects their ability to perform daily activities (Corbetta, 2014; Prigatano, 2014).…”

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confidence: 99%

Examining Anosognosia of Neglect

Grattan

Skidmore

Woodbury

2017

OTJR: Occupation, Participation and Health

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Background Unilateral neglect (neglect) and anosognosia often co-occur post-stroke. It is unknown whether anosognosia of neglect varies for different types of daily activities. Objectives To examine the frequency of anosognosia of neglect for items on the Catherine Bergego Scale (CBS) and determine the level of agreement between participant/assessor item ratings and total scores. Methods Secondary analysis of data. We conducted descriptive analyses and inter-rater reliability analyses (Cohen’s kappa) to determine the level of agreement between assessor and participant item ratings. A paired t-test was conducted to compare assessor and participant total scores. Results The frequency of anosognosia amongst items varied (29.2%-83.3%), and Kappa statistics ranged from −0.07 (no agreement) to 0.23 (fair agreement) for item ratings. There was a significant difference t(36) =3.02, p≤.01) between assessor (M=8.0, SD= 5.2) and participant-rated (M=5.3, SD=4.5) total CBS scores. Conclusion Anosognosia is prevalent among those with neglect. Findings highlight the importance of assessing for anosognosia.

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Assessing anosognosias after stroke: A review of the methods used and developed over the past 35 years

Cited by 32 publications

References 84 publications

Involvement of the Cingulate Cortex in Anosognosia: A Multimodal Neuroimaging Study in Alzheimer’s Disease Patients

Involvement of the Cingulate Cortex in Anosognosia: A Multimodal Neuroimaging Study in Alzheimer’s Disease Patients

Integrating the Constructs of Anosognosia and Metacognition: a Review of Recent Findings in Dementia

Examining Anosognosia of Neglect

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