Awareness is in the eye of the observer: Preserved third-person awareness of deficit in anosognosia for hemiplegia

Besharati, Sahba; Jenkinson, Paul M.; Kopelman, Michael; Solms, Mark; Moro, Valentina; Fotopoulou, Aikaterini

doi:10.1016/j.neuropsychologia.2022.108227

Cited by 3 publications

(7 citation statements)

References 51 publications

(62 reference statements)

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“…Similar results have been observed in the context of psychosis [32][33][34]. Additionally, findings suggest that unaware patients may be able to acknowledge deficits in others [35], something which has been observed in the case of anosognosia for hemiplegia [36][37][38], and psychosis [39]. By contrast, in left-braindamaged patients suffering from anosognosia for apraxia, video manipulation does not lead to improvement in evaluation of self-performance [40,41], but recognition of errors in others may still be preserved [40].…”

Section: Introductionsupporting

confidence: 73%

Self- and Other-Evaluation in Alzheimer’s Disease

Latgé-Tovar

Bertrand

Cosentino

et al. 2022

JAD

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Background: Impaired awareness of ability is common in dementia and has important clinical implications. Evidence from different clinical groups has shown that awareness can vary according to whether evaluation refers to self or other performance. Objective: The present study aimed to investigate awareness for self- and other-performance in Alzheimer’s disease (AD) patients, exploring if results vary according to cognitive domain of the tasks. It was hypothesized that, particularly for memory tasks, AD patients would be inaccurate in relation to self-but not other-performance. Methods: Twenty-two mild to moderate AD patients and twenty-two healthy older adults participated. Two tasks, with reaction time (RT) and working memory tasks, were carried out, and each had a success and a failure condition. Participants were asked to estimate their own performance, as well as the performance of another person they observed. Awareness of performance was measured comparing participant estimations of performance with actual performance. Results: For both the RT and working memory tasks, results indicate that participants from both groups overestimated the performance in the failure condition and underestimated the performance in the success condition. They tended to overestimate more the performance of the other person compared to themselves. Additionally, for the working memory task, AD patients tended to overestimate more performances compared to controls. Conclusion: Findings suggest that the AD and control groups present the same pattern, with attribution of better performance to another person. For the AD group, the pattern of response was different for memory tasks, which may suggest domain-specific limited awareness.

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Section: Introductionsupporting

confidence: 73%

Self- and Other-Evaluation in Alzheimer’s Disease

Latgé-Tovar

Bertrand

Cosentino

et al. 2022

JAD

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“…Drawing on the framework presented in Besharati et al (2022), the set of self-referent ToM stories yield questions to the participants that could be answered in egocentric ways, as they involved the patient (the self) in relation to another character (other 1, as in Figure 1). The set of other-referent ToM stories yield questions to the participants that could be answered in allocentric ways as they considered two agents that were unrelated to the self.…”

Section: Methodsmentioning

confidence: 99%

“…Important individual differences in performance can exist within groups when looking at differences in motor awareness (Besharati et al, 2022;D'Imperio et al, 2017;Marcel et al, 2004;Pacella et al, 2022) between experimental conditions or ToM tasks (Besharati et al, 2016). These individual differences can be masked by group level analysis.…”

Section: Individual-level Analysismentioning

confidence: 99%

“…Disorders of body awareness, such as anosognosia for hemiplegia (AHP; defined as the apparent unawareness of paralysis typically following lesions to the right hemisphere; Moro et al, 2021 but see Cocchini et al, 2009), have been key in revealing some of these neurocognitive mechanisms (Fotopoulou, 2015;Orfei et al, 2007;Pacella et al 2019). Furthermore, recent studies on AHP have revealed that a realistic appreciation of our motor abilities relies not only on sensorimotor integration, but also higher order deficits of metacognition (Kirsch et al, 2021;Vocat et al, 2010), emotional regulation (Besharati et al, 2014;D'Imperio et al, 2017) and social cognition (Besharati et al, 2016;Besharati et al, 2022). While deficits in metacognition and emotional regulation have been directly linked to the emergence of anosognosic beliefs via experimental manipulations of beliefs under different cognitive or emotional contexts (Kirsch et al, 2021;D'Imperio et al, 2017), only generic social cognition deficits have been studied in AHP and merely correlated with the presence and severity of symptoms, as explained below and better targeted in the present study.…”

Section: Introductionmentioning

confidence: 99%

“…This latter ability is called 'allocentric inference' in the social cognition literature (e.g. as in the inference "Thandi felt that Sergio was happy to see her") and is contrasted with 'egocentric inference' where the target of the mental states to be inferred is the self, as for example when one thinks that someone else is 'happy to see me' De Vignemont, 2005 andBesharati et al, 2022). Deficits in third person and allocentric inference were found to correlate mostly with the degree of anosognosic symptoms.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

What I think she thinks about my body: Social inferences about disability-related content in anosognosia for hemiplegia

Besharati,

Jenkinson,

Kopelman

et al. 2024

Preprint

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The neuropsychological disorder of anosognosia for hemiplegia (AHP) can offer unique insights into the neurocognitive processes of body consciousness and representation. Previous studies have found associations between selective social cognition deficits and anosognosia. In this study, we examine how such social cognition deficits may directly interact with representations of one’s body as disabled in AHP. To this end, we modified a set of previously validated Theory of Mind stories to create content that was related to post-stroke paralysis and to investigate differences between right hemisphere damage patients with (n = 19) and without (n = 19) AHP. We expected AHP patients to perform worse than controls when trying to infer paralysis-related mental states, and explored whether such differences further depended on the kind of inference patients were asked to perform (e.g. from a first versus a third person perspective). Using an advanced structural neuroimaging technique, we expected selective social cognitive deficits to be associated with posterior parietal cortex lesions, and the difficulty to associate self -beliefs with paralysis during mentalising to be associated with frontoparietal disconnections. Group and individual level results revealed that AHP patients performed worse than HP controls when trying to infer paralysis-related mental states, possibly driven by both social cognition deficits per se and more specific difficulties to take the perspective of paralysed individual. Lesion analyses results were significant only at exploratory levels, revealing some of the hypothesised lesions but also unexpected white matter disconnections in the posterior body and splenium of the corpus collosum as related to deficits-related self-referent perspective taking. The study has implications for the multi-layered nature of body awareness, including abstract, social perspectives and beliefs about the body.

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Motor awareness: a model based on neurological syndromes

Pacella

Moro

2022

Brain Struct Funct

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Awareness is in the eye of the observer: Preserved third-person awareness of deficit in anosognosia for hemiplegia

Cited by 3 publications

References 51 publications

Self- and Other-Evaluation in Alzheimer’s Disease

Self- and Other-Evaluation in Alzheimer’s Disease

What I think she thinks about my body: Social inferences about disability-related content in anosognosia for hemiplegia

Motor awareness: a model based on neurological syndromes

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