RT Journal Article
SR Electronic
T1 Dissociations and similarities in motor intention and motor awareness: the case of anosognosia for hemiplegia and motor neglect
JF Journal of Neurology, Neurosurgery & Psychiatry
JO J Neurol Neurosurg Psychiatry
FD BMJ Publishing Group Ltd
SP 416
OP 419
DO 10.1136/jnnp-2012-302838
VO 84
IS 4
A1 Francesca Garbarini
A1 Alessandro Piedimonte
A1 Manuela Dotta
A1 Lorenzo Pia
A1 Anna Berti
YR 2013
UL http://jnnp.bmj.com/content/84/4/416.abstract
AB Objectives To confront motor awareness in anosognosia for hemiplegia (AHP), where paralyzed patients deny their motor impairment, and in motor neglect (MN), where non-paralyzed patients behave as if they were paretic. Methods Eight right-brain-damaged-patients, 4 hemiplegic (2 with and 2 without AHP) and 4 non-hemiplegic (2 with only perceptual-neglect and 2 with also MN) were evaluated with a bimanual motor battery, before and after examiner's reinforcement to use the contralesional limb. The requested bimanual movements could be either symmetric or asymmetric, either intransitive or transitive (with/without objects). We compared the examiner's evaluation of patients' performance with the patients' self-evaluation of their own motor capability (explicit knowledge). We also evaluated the presence/absence of compensatory unimanual strategies that, if present, suggests implicit knowledge of the motor deficit. Results We found significant differences between conditions only in MN patients, whose performance was better after the examiner's reinforcement than before it, during symmetric than asymmetric movements and during intransitive than transitive movements. As for motor awareness, we found a lack of explicit and implicit knowledge in both AHP and MN patients. Conclusion Although different in terms of motor intention and motor planning, AHP and MN are both characterised by anosognosia for the motor impairment.