tesi sull'ANOSOGNOSIA

Anosognosia for motor impairment following left brain damage. Cocchini, Gianna; Beschin, Nicoletta; Cameron, Annette; Fotopoulou, Aikaterini; Della Sala, Sergio; Neuropsychology, Vol 23(2), Mar 2009. pp. 223-230. [Journal Article] Abstract: Anosognosia for motor impairment has been linked to lesions of the right hemisphere. However, left hemisphere damaged patients have often been excluded from investigation because of their associated language deficits. In this study we assessed anosognosia for motor disorders in a group of left hemisphere damaged patients using 2 tools that assess the presence of unawareness—a structured interview that is a common method of assessment of anosognosia in clinical settings, and a new tool, the Visual-Analogue Test for Anosognosia for Motor Impairment (VATAm; Della Sala, Cocchini, Beschin, & Cameron, in press). The structured interview relies heavily on language and enquires about general motor ability whereas the VATAm is less dependent on language abilities and enquires about specific motor tasks. Results suggest that the frequency of anosognosia in left brain damaged patients may have been underestimated due to methodological reasons, and that anosognosia for motor impairment can also be associated with lesions of the left hemisphere. (PsycINFO Database Record (c) 2009 APA, all rights reserved)

Unawareness of motor impairment and emotions in right hemispheric stroke: a preliminary investigation. By: Spalletta, Gianfranco; Serra, Laura; Fadda, Lucia; Ripa, Alessandra; Bria, Pietro; Caltagirone, Carlo. International Journal of Geriatric Psychiatry, Dec2007, Vol. 22 Issue 12, p1241-1246, 6p, 2 charts Abstract: Background Awareness may lack in some stroke patients who are not capable of evaluating the nature and severity of illness. Thus, unawareness may have different forms such as anosognosia, neglect, and alexithymia or unawareness of emotions. In this study we investigated the relationship among anosognosia, neglect, alexithymia, and cognition. Methods Fifty consecutive right stroke inpatients were approached within the first 3 months from the acute event. Anosognosia was measured with the Bisiach scale, alexithymia with the TAS-20 scale and neglect with line crossing, letter cancellation, figure and shape copying, and line bisection tests. A neuropsychological test battery was used to measure different areas of cognition. Results despite the strong comorbidity rate among the different forms of unawareness, there are patients who suffer from pure forms of these types of lack of awareness. A multivariate logistic regression model evidenced that presence of neglect (OR = 10.3; 95% CI = 1.4–76.3; p = 0.023) and more difficulty in describing feelings (TAS-20 F2 subscore; OR = 1.3; 95% CI = 1.1–1.7; p = 0.014) were the only predictors of anosognosia. In addition, anosognosics with alexithymia performed worst in a frontal task such as the verbal fluency task (p = 0.042) and in the verbal span forward task (p = 0.026) than pure anosognosics. Conclusions Anosognosia for motor impairment is strictly associated with a specific form of unawareness of emotions. Future studies have to clarify if frontal cognitive impairment previously described in anosognosics is a manifestation of unawareness of emotions or anosognosia for motor impairment. Copyright © 2007 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR] DOI: 10.1002/gps.1822 (AN 27610849)

Vascular cognitive impairment: perspective and review. By: Hyer, Lee; Damon, Jill; Nizam, Zeba. Journal of Psychiatry & Law, Fall2007, Vol. 35 Issue 3, p325-364, 40p Abstract: Mild Cognitive Impairment (MCI) is a construct that has received considerable interest in the last 15 years. One variant of MCI is Vascular Cognitive Impairment ( VCI), a relatively new idea with considerable importance. VCI is a reflection of cerebral vascular disease and is a prodrome of Vascular dementia. It is both prevalent and represents a marker that can be addressed and even prevented. Its presence suggests further decline, as well as current problems. In this article we address this heterogeneous condition and present a context. We discuss both Alzheimer's disease and vascular dementia, and consider the many variables related to vascular problems. We then consider MCI itself, with a focus on the relatively unstudied concept of mild vascular cognitive impairment. We address the cognitive features of this disease process and its implications for adjustment and potential problems. To illustrate these concepts, we will present a case, ways to assess it, and implications for treatment. We conclude by considering assessment and the issue of competence specific to VCI. [ABSTRACT FROM AUTHOR] (AN 31325074)

Anosognosia versus unilateral neglect. Coexistence and their relations to age, stroke severity, lesion site and cognition. By: Appelros, P.; Karlsson, G. M.; Hennerdal, S.. European Journal of Neurology, Jan2007, Vol. 14 Issue 1, p54-59, 6p, 4 charts Abstract: The aim of this study was to examine the association between anosognosia and unilateral neglect (UN), with special focus on age, stroke severity, lesion location and pre-stroke dementia. The basis of this investigation was a population-based stroke incidence study. Anosognosia was assessed using a questionnaire, and UN using a three-item version of the Behaviour Inattention Test, the Baking Tray Task and a test of personal neglect. Stroke severity was assessed using the NIH stroke scale. Patients with anosognosia were older, and they more often had pre-stroke dementia than patients having UN only. No particular lesion localization was associated with anosognosia, while UN was strongly associated with previously defined lesion sites, often in the parietal lobe. There was a borderline significance regarding stroke severity in patients having anosognosia compared with those with UN only. Patients with anosognosia had higher mortality than patients without, but when controlled for age and stroke severity, this effect was not independent. While UN is closely associated with ‘classical’ lesion sites, anosognosia is a condition that more often occurs in a previously impaired brain. For anosognosia, lesion location appears to be less important. Anosognosia also tends to occur with larger strokes. [ABSTRACT FROM AUTHOR] DOI: 10.1111/j.1468-1331.2006.01544.x (AN 23626915)

Misoplegia. By: Pearce, J. M. S.. European Neurology, 2007, Vol. 57 Issue 1, p62-64, 3p Abstract: Amongst the many fascinating abnormal perceptions of parts of the body which may follow strokes and other cerebral lesions is the rare phenomenon of misoplegia. Afflicted patients show dislike, amounting to hatred of the affected part, often accompanied by verbal or physical abuse. Most often the result of a right hemisphere lesion, its precise mechanisms are not well understood. This is a summary of misoplegia and its alleged physiological mechanisms. Copyright © 2007 S. Karger AG, Basel [ABSTRACT FROM AUTHOR] DOI: 10.1159/000097122 (AN 23698691)

Anosognosia after stroke: assessment, occurrence, subtypes and impact on functional outcome reviewed. By: Jehkonen, M.; Laihosalo, M.; Kettunen, J.. Acta Neurologica Scandinavica, Nov2006, Vol. 114 Issue 5, p293-306, 14p, 7 charts Abstract: Purpose – This review provides an update on recent research findings concerning the methods used in the assessment of anosognosia, the occurrence and subtypes of anosognosia, the association between anosognosia and neglect, and the impact of anosognosias on functional outcome. Methods – A systematic review covering the period from 1995 to 2005 was carried out on reports drawn from electronic databases (MEDLINE, PSYCHLIT) and identified from the references in these reports. Twenty-seven articles met the selection criteria. Results – The results of this review are in line with previous findings in the following respects: anosognosia was more often associated with right hemisphere damage, neglect and anosognosia co-occurred, and anosognosia had predictive value on poor functional outcome. The variation in the methods used in the assessment of anosognosia, patient samples and assessment times influence the occurrence rates and the predictive value of anosognosia, which might undermine the generalizability of the results. Conclusions – More homogeneous patient samples and consistency in the assessment methods and evaluation times would facilitate comparisons of the occurrence and the impact of anosognosia on functional outcome. New methods need to be developed for the assessment of anosognosia. These new methods should take account of the subtypes of anosognosia both at verbal and at non-verbal levels. [ABSTRACT FROM AUTHOR] DOI: 10.1111/j.1600-0404.2006.00723.x (AN 22566866)

Intoxication Anosognosia: The Spellbinding Effect of Psychiatric Drugs. By: Breggin, Peter R.. Ethical Human Psychology & Psychiatry, Fall2006, Vol. 8 Issue 3, p201-215, 15p Abstract: Why do so many individuals persist in taking psychoactive substances, including psychiatric drugs, after adverse mental and behavioral effects have become severe and even disabling? The author has previously proposed the brain-disabling principle of psychiatric treatment that all somatic psychiatric treatments impair the function of the brain and mind. Intoxication anosognosia (medication spellbinding) is an expression of this drug-induced mental disability. Intoxication anosognosia causes the victim to underestimate the degree of drug-induced mental impairment, to deny the harmful role that the drug plays in the person's altered state, and in many cases compel the individual to mistakenly believe that he or she is functioning better. In the extreme, the individual displays out-of-character compulsively destructive behaviors, including violence toward self and others. [ABSTRACT FROM AUTHOR] (AN 25121050)

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