Phenomenology and neural correlates of implicit and emergent motor awareness in patients with anosognosia for hemiplegia

Moro, Valentina; Pernigo, Simone; Zapparoli, P.; Cordioli, Zeno; Aglioti, Salvatore Maria

doi:10.1016/j.bbr.2011.07.010

Cited by 82 publications

(108 citation statements)

References 59 publications

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“…We found a trend but not a statistically reliable relationship between the two. This finding is consistent with studies that have not found strong associations between metacognitive and indirect measures of awareness in other domains of cognitive impairment and following different types of acquired brain injury (e.g., Hoerold, Pender & Robertson, 2013;O'Keeffe et al, 2007;Cocchini, Beschin, Fotopoulou & Della Sala, 2010;Moro, Pernigo, Zapparoli, Cordioli, & Aglioti, 2011).…”

Section: Discussionsupporting

confidence: 91%

Anosognosia and self-correction of naming errors in aphasia

Dean

Sala

Beschin³

et al. 2016

Aphasiology

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Section: Discussionsupporting

confidence: 91%

Anosognosia and self-correction of naming errors in aphasia

Dean

Sala

Beschin³

et al. 2016

Aphasiology

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“…AHP is most frequently caused by right perisylvian lesions, but is also reported in left-sided brain damaged patients (Cocchini, Beschin, Cameron, Fotopoulou, & Della Sala, 2009). Although lesions of the right posterior insula (Karnath, Baier, & Nagele, 2005) and premotor cortex (Berti et al, 2005) have been selectively associated with AHP, more recent results point to additional, critical lesion sites including subcortical structures (basal ganglia, hippocampus, amygdala) and deep white matter tracts (Fotopoulou, Pernigo, Maeda, Rudd, & Kopelman, 2010;Moro, Pernigo, Zapparoli, Cordioli, & Aglioti, 2011;Vocat, Staub, Stroppini, & Vuilleumier, 2010).…”

Section: Introductionmentioning

confidence: 99%

“…It can also vary in specificity (i.e., exclusively involving the upper or the lower limb) and extension (i.e., ability to recognise a deficit but not its functional consequences) (see Fotopoulou, 2012 andMarcel et al, 2004). Furthermore, clinical and experimental studies have demonstrated that certain patients have tacit or implicit awareness into their deficits, while being explicitly unaware of them Nardone, Ward, Fotopoulou, & Turnbull, 2008) and vice versa Moro et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Another perspective on anosognosia: Self-observation in video replay improves motor awareness

Besharati

Kopelman

Avesani

et al. 2014

Neuropsychological Rehabilitation

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Anosognosia for hemiplegia (AHP), or unawareness of motor deficits contralateral to a brain lesion, has lasting negative implications for the management and rehabilitation of patients. A recent, bedside psychophysical intervention, namely self-observation by video replay, lead to a lasting remission of severe AHP in an acute stroke patient (Fotopoulou, A., Rudd, A., Holmes, P., & Kopelman, M. (2009). Self-observation reinstates motor awareness in anosognosia for hemiplegia. Neuropsychologia, 47, 1256-1260). This procedure has been adjusted and applied here, as the basis of two intervention protocols administered independently to two patients with severe AHP. The first study used multiple, successive sessions of video-based self-observation in an acute patient, targeting first the awareness of upper limb and subsequently lower limb paralysis. The second study used a single session of video-based, self- and other-observation in a patient at the chronic stage following onset. Both protocols also involved elements of rapport building and emotional support. The results revealed that video-based self-observation had dramatic, immediate effects on awareness in both acute and chronic stages and it seemed to act as an initial trigger for eventual symptom remission. Nevertheless, these effects did not automatically generalise to all functional domains. This study provides provisional support that video-based self-observation may be included in wider rehabilitation programmes for the management and restoration of anosognosia.

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“…It must, however, be considered that a growing number of studies (e.g., Ramachandran, 1995;Marcel et al, 2004;Nardone et al, 2007;Fotopoulou et al, 2010;Preston, Jenkinson, & Newport, 2010;Moro et al, 2011;Garbarini et al, 2012;Prigatano, 2014) A further observation concerns the 'similar performance' (scores) observed between anosognosic patients and healthy volunteers during the Current condition. Patients unaware of their motor impairment perceived the difficulty of the tasks similarly to healthy volunteers, as if they could still use both hands.…”

Section: Discussionmentioning

confidence: 99%

Unawareness for Motor Impairment and Distorted Perception of Task Difficulty

Cocchini

Beschin

Sala

2017

J Int Neuropsychol Soc

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Words: 4881 (references and abstract excluded) Cocchini et al. Unawareness and distorted perception of task difficulty 2 ABSTRACT Objective: Anosognosia for motor impairment is a complex syndrome that can manifest itself under different forms, guiding patients' behaviour and task decisions. However, current diagnostic tools tend to evaluate only more explicit aspects of anosognosia (asking the patients about their motor abilities) and fail to address more subtle features of awareness. We have developed a new assessment measure, the ECT (Errand Choice Test), where patients are asked to judge task difficulty rather than estimate their own impairment. Method: We assessed awareness in a group of 73 unilateral left-and right-brain damaged (30 LBD and 43 RBD, respectively) patients by means of the VATAm, which explicitly requires them to evaluate their own motor abilities, and the ECT. A control group of 65 healthy volunteers was asked to perform the ECT under two conditions: Current condition (i.e. using both hands) and Simulated conditions (i.e. simulating hemiplegia). Results: 27% of the patients showed different performance on the VATAm and ECT, 21% of the patients showing lack of awareness only on VATAm and 6% only on ECT. Moreover, despite the ECT identified a higher frequency of anosognosia after RBD (33.3%) than LBD (27.6%), this hemispheric asymmetry was not significant. Remarkably, anosognosic patients performed very similarly to controls in the 'current condition', suggesting that anosognosic patients' ability to perceive the complexity of each task per se is not altered. Conclusion: Different methods may be able to tackle different aspects of awareness and the ECT proved to be able to detect less evident forms of awareness.

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Phenomenology and neural correlates of implicit and emergent motor awareness in patients with anosognosia for hemiplegia

Cited by 82 publications

References 59 publications

Anosognosia and self-correction of naming errors in aphasia

Anosognosia and self-correction of naming errors in aphasia

Another perspective on anosognosia: Self-observation in video replay improves motor awareness

Unawareness for Motor Impairment and Distorted Perception of Task Difficulty

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