Anosognosia and patterns of impaired self-awareness observed in clinical practice

Behavioural and neuroimaging correlates of impaired self-awareness of hypo- and hyperkinesia in Parkinson's disease

“…While the term anosognosia refers to a complete lack of self-perceived neurological or neuropsychological deficits, impaired self-awareness (ISA) defines a partial absence of neurological disease self-perception (G. P. Prigatano, 2014). A reduced awareness of one's neurological symptoms has been associated with less adherence, higher patient mortality and caregiver burden as well as earlier institutionalization and is therefore of high clinical relevance (Appelros, Karlsson, & Hennerdal, 2007;Koltai, Welsh-Bohmer, & Schmechel, 2001; G.P.…”

Examining Anosognosia of Neglect

“…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). Hence, this study uniquely focuses on anosognosia of neglect .…”

Unawareness for Motor Impairment and Distorted Perception of Task Difficulty

“…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.…”

“…Invariably, these evaluations imply some degree of metacognition: patients are asked to estimate their own motor skills and, in some cases, they are asked to comment on their previous performance and use of strategies (Moro, Scandola, Bulgarelli, Avesani, & Fotopoulou, 2015). However, there is evidence to suggest that lack of explicit awareness may be associated to some degree of insight (e.g., Marcel et al, 2004;House & Houdges, 1988;Nardone, Ward, Fotopoulou, & Turnbull, 2007;Cocchini, Beschin, Fotopoulou, & Della Sala, 2010;Fotopoulou, Pernigo, Maeda, Rudd, & Kopelman, 2010;Prigatano, 2014;D'Imperio, Bulgarelli, Bertognoli, Avesani, & Moro, 2017). Patients may verbally deny their motor deficits yet abstain from activities requiring the use of both hands (Bisiach & Geminiani, 1991) or adopt successful strategies in approaching bi-manual tasks using one hand Moro, Pernigo, Zapparoli, Cordioli, & Aglioti, 2011;Garbarini, Piedimonte, Dotta, Pia & Berti, 2013) or refrain to perform potentially dangerous activities for hemiplegic patients (D'Imperio et al, 2017).…”

“…Patients may be asked to respond to structured interviews investigating their ability to move their limbs (Jenkinson, Preston, & Ellis, 2011;Nurmi & Jehkonen, 2014 -see also Table 1) or to rate their motor performances in everyday tasks (e.g., Marcel, Tegnér, & Nimmo-Smith, 2004;, Prigatano, 2014 Table 1). Invariably, these evaluations imply some degree of metacognition: patients are asked to estimate their own motor skills and, in some cases, they are asked to comment on their previous performance and use of strategies (Moro, Scandola, Bulgarelli, Avesani, & Fotopoulou, 2015).…”