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Mentalizing the body: spatial and social cognition in anosognosia for hemiplegia

Following right-hemisphere damage, a specific disorder of motor awareness can occur called anosognosia for hemiplegia, i.e. the denial of motor deficits contralateral to a brain lesion. The study of anosognosia can offer unique insights into the neurocognitive basis of awareness. Typically, however,...

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Autores principales: Besharati, Sahba, Forkel, Stephanie J., Kopelman, Michael, Solms, Mark, Jenkinson, Paul M., Fotopoulou, Aikaterini
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4766377/
https://www.ncbi.nlm.nih.gov/pubmed/26811254
http://dx.doi.org/10.1093/brain/awv390
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author Besharati, Sahba
Forkel, Stephanie J.
Kopelman, Michael
Solms, Mark
Jenkinson, Paul M.
Fotopoulou, Aikaterini
author_facet Besharati, Sahba
Forkel, Stephanie J.
Kopelman, Michael
Solms, Mark
Jenkinson, Paul M.
Fotopoulou, Aikaterini
author_sort Besharati, Sahba
collection PubMed
description Following right-hemisphere damage, a specific disorder of motor awareness can occur called anosognosia for hemiplegia, i.e. the denial of motor deficits contralateral to a brain lesion. The study of anosognosia can offer unique insights into the neurocognitive basis of awareness. Typically, however, awareness is assessed as a first person judgement and the ability of patients to think about their bodies in more ‘objective’ (third person) terms is not directly assessed. This may be important as right-hemisphere spatial abilities may underlie our ability to take third person perspectives. This possibility was assessed for the first time in the present study. We investigated third person perspective taking using both visuospatial and verbal tasks in right-hemisphere stroke patients with anosognosia ( n = 15) and without anosognosia ( n = 15), as well as neurologically healthy control subjects ( n = 15). The anosognosic group performed worse than both control groups when having to perform the tasks from a third versus a first person perspective. Individual analysis further revealed a classical dissociation between most anosognosic patients and control subjects in mental (but not visuospatial) third person perspective taking abilities. Finally, the severity of unawareness in anosognosia patients was correlated to greater impairments in such third person, mental perspective taking abilities (but not visuospatial perspective taking). In voxel-based lesion mapping we also identified the lesion sites linked with such deficits, including some brain areas previously associated with inhibition, perspective taking and mentalizing, such as the inferior and middle frontal gyri, as well as the supramarginal and superior temporal gyri. These results suggest that neurocognitive deficits in mental perspective taking may contribute to anosognosia and provide novel insights regarding the relation between self-awareness and social cognition.
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spelling pubmed-47663772016-02-26 Mentalizing the body: spatial and social cognition in anosognosia for hemiplegia Besharati, Sahba Forkel, Stephanie J. Kopelman, Michael Solms, Mark Jenkinson, Paul M. Fotopoulou, Aikaterini Brain Original Articles Following right-hemisphere damage, a specific disorder of motor awareness can occur called anosognosia for hemiplegia, i.e. the denial of motor deficits contralateral to a brain lesion. The study of anosognosia can offer unique insights into the neurocognitive basis of awareness. Typically, however, awareness is assessed as a first person judgement and the ability of patients to think about their bodies in more ‘objective’ (third person) terms is not directly assessed. This may be important as right-hemisphere spatial abilities may underlie our ability to take third person perspectives. This possibility was assessed for the first time in the present study. We investigated third person perspective taking using both visuospatial and verbal tasks in right-hemisphere stroke patients with anosognosia ( n = 15) and without anosognosia ( n = 15), as well as neurologically healthy control subjects ( n = 15). The anosognosic group performed worse than both control groups when having to perform the tasks from a third versus a first person perspective. Individual analysis further revealed a classical dissociation between most anosognosic patients and control subjects in mental (but not visuospatial) third person perspective taking abilities. Finally, the severity of unawareness in anosognosia patients was correlated to greater impairments in such third person, mental perspective taking abilities (but not visuospatial perspective taking). In voxel-based lesion mapping we also identified the lesion sites linked with such deficits, including some brain areas previously associated with inhibition, perspective taking and mentalizing, such as the inferior and middle frontal gyri, as well as the supramarginal and superior temporal gyri. These results suggest that neurocognitive deficits in mental perspective taking may contribute to anosognosia and provide novel insights regarding the relation between self-awareness and social cognition. Oxford University Press 2016-03 2016-01-24 /pmc/articles/PMC4766377/ /pubmed/26811254 http://dx.doi.org/10.1093/brain/awv390 Text en © The Author (2016). Published by Oxford University Press on behalf of the Guarantors of Brain. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/ ), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Original Articles
Besharati, Sahba
Forkel, Stephanie J.
Kopelman, Michael
Solms, Mark
Jenkinson, Paul M.
Fotopoulou, Aikaterini
Mentalizing the body: spatial and social cognition in anosognosia for hemiplegia
title Mentalizing the body: spatial and social cognition in anosognosia for hemiplegia
title_full Mentalizing the body: spatial and social cognition in anosognosia for hemiplegia
title_fullStr Mentalizing the body: spatial and social cognition in anosognosia for hemiplegia
title_full_unstemmed Mentalizing the body: spatial and social cognition in anosognosia for hemiplegia
title_short Mentalizing the body: spatial and social cognition in anosognosia for hemiplegia
title_sort mentalizing the body: spatial and social cognition in anosognosia for hemiplegia
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4766377/
https://www.ncbi.nlm.nih.gov/pubmed/26811254
http://dx.doi.org/10.1093/brain/awv390
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