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Anosognosia
Published in Alexander R. Toftness, Incredible Consequences of Brain Injury, 2023
Anosognosia refers to a disorder wherein a person has a problem of some kind, such as an illness, but is unaware that the problem exists or otherwise greatly underestimates the severity of the problem (Nurmi & Jehkonen, 2014). Their brain fails to update their knowledge of themselves with the new problem that they are experiencing, so they do not realize that it is happening. The type of problems that people with anosognosia fail to acknowledge are extremely diverse, and the definition can be broad enough to potentially include all of the other conditions contained in this book. Because anosognosia modifies other conditions, you will see it written as “anosognosia for ______,” with the blank filled in by whatever condition the person has but of which they are unaware.
Recognising and engaging with spatial cognition problems
Published in Ross Balchin, Rudi Coetzer, Christian Salas, Jan Webster, Addressing Brain Injury in Under-Resourced Settings, 2017
Ross Balchin, Rudi Coetzer, Christian Salas, Jan Webster
To evaluate whether the patient has anosognosia, follow these steps: Step 1 – Assess the patient’s orientation to personOrientation to person (see Chapter 5) will provide the first indication of whether the patient is aware of their medical problems. Remind yourself of whether the patient voluntarily reported any problems.
Cerebrovascular accidents, intracranial tumors, and urologic consequences
Published in Jacques Corcos, David Ginsberg, Gilles Karsenty, Textbook of the Neurogenic Bladder, 2015
David J. Osborn, W. Stuart Reynolds, Roger R. Dmochowski
Pettersen et al. assessed how functional status after a CVA relates to urinary symptoms and overall outcomes in stroke patients. The authors recorded the mental status, functional status, and urinary symptoms of 315 patients with acute stroke. Patients with impaired awareness were found to have the poorest outcomes and the least improvement in urinary function 3 months after their stroke.44 The authors attributed this impairment in awareness to anosognosia, which is unawareness or denial of a neurologic deficit. Other studies have attributed anosognosia to more severe overall disability, and this finding is an independent predictor of poor outcome in these patients.45 When patients with a CVA develop self-neglect, their inability to recognize basic needs, such as the need to void and perform hygiene, adds to their overall disability and leads to a worse outcome than those in whom these executive functions are intact.46
Conceptualization of self-awareness in adults with acquired brain injury: A qualitative systematic review
Published in Neuropsychological Rehabilitation, 2022
Danielle Sansonetti, Jennifer Fleming, Freyr Patterson, Natasha A. Lannin
The terminology used to describe “self-awareness” varied across papers, with 12 different definitions provided that described knowledge about self, impairments, and problems encountered or anticipated; and considered both past, present, and future experiences that inform self-awareness. Eight definitions of “impaired self-awareness” were provided, with descriptions being on a continuum of partial or complete loss of information or knowledge about deficits or problems. Papers included 20 different definitions of “anosognosia”, with description ranging from a total lack of, to diminished knowledge of, deficit or disability; difficulty acknowledging or recognizing abilities, and denial of illness. See Table 3 for a synthesis of the definitions found in the review.
Long-term cognitive disability after traumatic brain injury: Contribution of the DEX relative questionnaires
Published in Neuropsychological Rehabilitation, 2020
Blandine Lesimple, Elsa Caron, Muriel Lefort, Clara Debarle, Mélanie Pélégrini-Issac, Didier Cassereau, Sébastien Delphine, Grégory Torkomian, Valentine Battisti, Pierrette Bossale, Damien Galanaud, Louis Puybasset, Pascale Pradat-Diehl, Vincent Perlbarg
As far as anosognosia is concerned, results are heterogeneous from one study to another in the literature concerning the brain network involved in self-awareness. For example, according to Morton and Barker (2010), this complex process may imply prefrontal, inferior parietal and anterior temporal lobes, angular gyrus and supramarginal gyrus and, more generally, involve the anterior cingulate cortex, the anterior insula and fronto-parietal areas (Craig, 2009), which could be affected by a diffuse brain injury rather than a focal lesion (Morton & Barker, 2010). Anosognosia could be a dysfunctional result of a more extensive and distinct cerebral network (Morton & Barker, 2010). In this context, mean diffusivity is a measure that allows one to evaluate microstructural white matter integrity. After a mild TBI, Kinnunen et al. (2011) and Messé et al. (2011) have shown that an increased MD value could discriminate patients with poor outcome from those with a good outcome and from controls, three months after injury. Haberg et al. (2015) reported a correlation between the mean of MD measures and GOSE in TBI patients. Our results showed a link between global white matter alteration (in terms of MD value) and anosognosia, suggesting that anosognosia, even at long term after TBI, could be a consequence of brain damages.
A combined therapy for limb apraxia and related anosognosia
Published in Neuropsychological Rehabilitation, 2020
Ilka Buchmann, Lisa Finkel, Mareike Dangel, Dorothee Erz, Kathi Maren Harscher, Moritz Kaupp-Merkle, Joachim Liepert, Brigitte Rockstroh, Jennifer Randerath
Also, none of the trainings included supported self-evaluation as an approach to address a lack of insight into the impairment (anosognosia) of solving naturalistic actions, despite the fact that anosognosia has been reported to potentially co-occur with limb apraxia (Buchmann, Jung, Liepert, & Randerath, 2018; Kusch et al., 2018) and that the performance of apraxic patients could benefit when monitoring their errors (Morady & Humphreys, 2009). Anosognosia should be taken into account for therapy approaches. A lack of insight into the impairment leads to reduced rehabilitation motivation (Buxbaum et al., 2008; Fleming, Strong, & Ashton, 1998; Peskine & Azouvi, 2007) and less independence in activities of daily life after rehabilitation discharge (Pedersen, Jorgensen, Nakayama, Raaschou, & Olsen, 1996).