6533b852fe1ef96bd12ab697

RESEARCH PRODUCT

Anosognosia for hemiparesis after left-sided stroke

Hans-otto KarnathGoran VucurevicMarianne DieterichWibke Müller-forellBernhard BaierChristian GeberO. Glassl

subject

Malemedicine.medical_specialtyCognitive Neurosciencemedia_common.quotation_subjectHemiplegiaExperimental and Cognitive PsychologyContext (language use)Left sidedLateralization of brain functionNeglectPhysical medicine and rehabilitationImage Processing Computer-AssistedmedicineHumansStrokeAgedmedia_commonmedicine.diagnostic_testAnosognosiaAwarenessMiddle Agedmedicine.diseaseMagnetic Resonance ImagingParesisStrokeNeuropsychology and Physiological PsychologyHemiparesisAgnosiaFemalemedicine.symptomFunctional magnetic resonance imagingPsychologyCognitive psychology

description

In patients with left-sided lesions, anosognosia for hemiparesis (AHP) seems to be a rare phenomenon. It has been discussed whether this rareness might be due to an inevitable bias due to language dysfunction and whether the left hemisphere's role for our self-awareness of motor actions thus is underestimated. By applying functional magnetic resonance imaging (fMRI) we examined whether patients with AHP following a left hemisphere stroke show a regular, left-sided or a reversed, right-sided lateralization of language functions. Only the former observation would argue for an original role of the left hemisphere in self-awareness about limb function. In a consecutive series of 44 acute left-sided stroke patients, only one patient (=2%) was identified showing AHP. In this case, we could verify by using fMRI that lateralization of AHP and spatial neglect on the one hand and of language functions on the other hand were reversed. The present single case observation thus argues against an original role of the left hemisphere in self-awareness about limb function. We discuss the data in the context of previous observations in the literature.

https://doi.org/10.1016/j.cortex.2014.07.017