Poor self-awareness of levodopa-induced dyskinesias in Parkinson's disease: Clinical features and mechanisms

Pietracupa, Sara; Fasano, Alfonso; Fabbrini, Giovanni; Sarchioto, Marianna; Bloise, Maria; Latorre, Anna; Altieri, Marta; Bologna, Matteo; Berardelli, Alfredo

doi:10.1016/j.parkreldis.2013.07.002

Cited by 58 publications

(63 citation statements)

References 21 publications

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“…In this regard, we observed that PD patients are less aware of LID in the trunk (9). Although there is no clear explanation for this finding, some neurophysiological observations may help to shed light on the issue.…”

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confidence: 75%

“…In other words, patients with more severe symptoms on the left side of the body were less aware of their motor and functional deficit than patients with more severe symptoms on the right side of the body. In a recent work, we investigated awareness of LID in 30 PD patients who had no cognitive dysfunction (9). In that study, which was based on a video protocol, we initially found that 23.3% of the patients investigated were unaware of the presence of their LID.…”

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confidence: 99%

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Parkinsonian Patients and Poor Awareness of Dyskinesias

et al. 2014

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Parkinsonian Patients and Poor Awareness of Dyskinesias

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“…The majority of studies focused on tardive dyskinesias (10)(11)(12)(13). In their recent study Pietracupa et al (12) found that seven of the 30 Parkinson's disease patients investigated were subjectively unaware of the presence of their levodopa induced-dyskinesias; the majority of patients, however, recognized their dyskinesias when watching video recording of themselves. The authors hypothesized that dyskinesias unawareness was a form of anosognosia.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Symptom severity in patients with functional motor symptoms: Patient's perception and doctor's clinical assessment

Ricciardi

Demartini

Morgante

et al. 2015

Parkinsonism & Related Disorders

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“…Anosognosia of chorea has also been described in the case of choreic dyskinesias in PD [7,11,15] and drug-induced dyskinesias in schizophrenia [16]. Two studies compared awareness of chorea in HD and Parkinson's disease (PD).…”

Section: Insight Into Motor Impairmentmentioning

confidence: 99%

Unawareness of Deficits in Huntington's Disease

Sitek

Thompson

Craufurd³

et al. 2014

Journal of Huntington's Disease

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People with Huntington's disease (HD) may show reduced awareness of physical and mental changes in themselves. This article reviews the evidence for loss of awareness (anosognosia) in an attempt to elucidate its characteristics and possible underlying mechanisms. It is shown that defective awareness occurs across domains. People with HD may under-report the presence or severity of involuntary movements, under-estimate cognitive impairment and deny behavioural change. Nevertheless, awareness is not all or none. Moreover, it may be affected differentially for different symptom domains and emerge at different stages of disease, raising the possibility of distinct contributory mechanisms. Findings of an inverse relationship between insight and severity of disease suggest that cognitive impairment, in particular executive dysfunction, may be an important contributory factor. Evidence has accrued to support this argument. However, cognitive impairment cannot fully account for patients' lack of awareness of involuntary movements. Findings that patients accurately report consequences but not the experience of involuntary movements, and better acknowledge their presence when watching videotapes of themselves suggests that physiological factors play an important role. The putative role of denial as a coping mechanism is discussed. Recognition by clinicians of deficient self-awareness is crucial because of its implications for diagnosis and optimal clinical management of HD.

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Poor self-awareness of levodopa-induced dyskinesias in Parkinson's disease: Clinical features and mechanisms

Cited by 58 publications

References 21 publications

Parkinsonian Patients and Poor Awareness of Dyskinesias

Parkinsonian Patients and Poor Awareness of Dyskinesias

Symptom severity in patients with functional motor symptoms: Patient's perception and doctor's clinical assessment

Unawareness of Deficits in Huntington's Disease

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