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Unawareness for Motor Impairment and Distorted Perception of Task Difficulty

Published online by Cambridge University Press:  24 August 2017

Gianna Cocchini ,
Nicoletta Beschin  and
Sergio Della Sala
Gianna Cocchini*
Affiliation:
Department of Psychology, Goldsmiths University of London, United Kingdom Blackheath Brain Injury Rehabilitation Centre and Neurodisability Service, London, United Kingdom
Nicoletta Beschin
Affiliation:
Clinical Neuropsychology Unit, Rehabilitation Department, Hospital S. Antonio Abate, Gallarate (Varese), Italy
Sergio Della Sala
Affiliation:
Human Cognitive Neuroscience, Psychology, University of Edinburgh, Edinburgh, United Kingdom
*
Correspondence and reprint requests to: Gianna Cocchini, Psychology Department, Goldsmiths University of London, New Cross, London SE14 6NW, UK. E-mail: g.cocchini@gold.ac.uk
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Abstract

Objectives: Anosognosia for motor impairment is a complex syndrome that can manifest itself under different forms, guiding patients’ behavior and task decisions. However, current diagnostic tools tend to evaluate only more explicit aspects of anosognosia (asking the patients about their motor abilities) and fail to address more subtle features of awareness. We have developed a new assessment measure, the ECT (Errand Choice Test), where patients are asked to judge task difficulty rather than estimate their own impairment. Methods: We assessed awareness in a group of 73 unilateral left- and right-brain damaged (30 LBD and 43 RBD, respectively) patients by means of the VATAm, which explicitly requires them to evaluate their own motor abilities, and the ECT. A control group of 65 healthy volunteers was asked to perform the ECT under two conditions: Current condition (i.e., using both hands) and Simulated conditions (i.e., simulating hemiplegia). Results: A total of 27% of the patients showed different performance on the VATAm and ECT, 21% of the patients showing lack of awareness only on VATAm and 6% only on ECT. Moreover, despite the ECT identified a higher frequency of anosognosia after RBD (33.3%) than LBD (27.6%), this hemispheric asymmetry was not significant. Remarkably, anosognosic patients performed very similarly to controls in the “current condition”, suggesting that anosognosic patients’ ability to perceive the complexity of each task per se is not altered. Conclusion: Different methods may be able to tackle different aspects of awareness and the ECT proved to be able to detect less evident forms of awareness. (JINS, 2018, 24, 45–56)

Keywords

AnosognosiaUnawarenessHemiplegiaAssessmentBrain damageImplicit
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 24 , Issue 1 , January 2018 , pp. 45 - 56
Copyright
Copyright © The International Neuropsychological Society 2017 

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