The riddle of anosognosia: Does unawareness of hemiplegia involve a failure to update beliefs?

Statistical Learning as a Tool for Rehabilitation in Spatial Neglect

“…Importantly, all subjects correctly identified the beginning and ending pictures, as well as catch trials in which simple geometric figures were inserted into the sequence. These data are in good agreement with those of Vocat et al (2012), who tested right brain damaged patients with anosognosia on a riddle test. Participants listened to five increasingly specific clues (for example, for the targeted word “ airplane ,” they were given the clues: “ I have wings ,” “ I can fly ,” and then the last clue was “ I have wheels ”).…”

“…The authors found that anosognosic patients reported higher levels of certainty regarding their initial guesses associated with the first clue (even those that were not particularly informative) and to preserve their response, although the next clues disconfirmed their guess. For example, with the clue “ my weight is approximately 300 grams ” and the target word “ heart ,” a patient guessed the word “ bread ,” and then with the next clue, “ I produce a regular sound ,” he persisted with the answer “ bread ” but justified it by saying it’s the noise that the knife makes when we cut bread (Vocat et al, 2012). The authors concluded that patients were impaired in creating and adapting beliefs to new information: they were overconfident about their initial guesses and failed to revise those guesses when successive clues were incongruent with that guess.…”

Inter-individual variability in metacognitive ability for visuomotor performance and underlying brain structures

“…Lastly, it is hard to determine with the current design whether the nature of signals used in right anterior insula for metacognitive evaluation is visual, motor, proprioceptive, or a combination of these aspects. Future functional and connectivity neuroimaging studies should also clarify the exact functional role and the extent of implication of the right insula in metacognitive mechanisms, particularly in populations of patients with disorders of movement awareness, including patients with schizophrenia (Klein et al, 2013) or anosognosia (Vocat, Saj, & Vuilleumier, 2013;Vuilleumier, 2004), but also those with functional neurological symptoms such as motor conversion (Vuilleumier, 2014;Vuilleumier et al, 2001).…”

Anosognosia in patients with acute hemispheric ischemic stroke

“…Наши данные подтверждают мнение R.Vocat и соавт. [8] о том, что нарушение регуляторных функций имеет клю-чевое значение для возникновения анозогнозии, посколь-ку приводит к невозможности «обновления» пациентом своих убеждений относительно измененного в результате болезни состояния.…”

“…Расширение представлений об анозогнозии, использо-вание разных диагностических критериев и неодинаковые сроки проведения исследований, -все это приводит к про-тиворечивости сведений о ее распространенности, морфо-логических основах и месте в структуре нейропсихологиче-ских и неврологических синдромов при инсульте [5][6][7][8]. Ме-жду тем прояснение этих вопросов может способствовать улучшению диагностики анозогнозии у больного инсультом и своевременной коррекции стратегии нейрореабилитации.…”