Anosognosia for hemiplegia as a tripartite disconnection syndrome
Valentina Pacella,
Chris Foulon,
Paul M Jenkinson,
Michele Scandola,
Sara Bertagnoli,
Renato Avesani,
Aikaterini Fotopoulou,
Valentina Moro,
Michel Thiebaut de Schotten
Affiliations
Valentina Pacella
Social and Cognitive Neuroscience Laboratory, Department of Psychology, Sapienza University of Rome, Rome, Italy; NPSY.Lab-VR, Department of Human Sciences, University of Verona, Verona, Italy
Brain Connectivity and Behaviour Laboratory, Sorbonne Universities, Paris, France; Frontlab, Institut du Cerveau et de la Moelle épinière (ICM), UPMC UMRS 1127, Inserm U 1127, CNRS UMR 7225, Paris, France; Computational Neuroimaging Laboratory, Department of Diagnostic Medicine, The University of Texas at Austin Dell Medical School, Austin, United States
Paul M Jenkinson
School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
Michele Scandola
NPSY.Lab-VR, Department of Human Sciences, University of Verona, Verona, Italy
Sara Bertagnoli
NPSY.Lab-VR, Department of Human Sciences, University of Verona, Verona, Italy
Renato Avesani
Department of Rehabilitation, IRCSS Sacro Cuore-Don Calabria Hospital, Verona, Italy
Aikaterini Fotopoulou
Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, London, United Kingdom
Valentina Moro
NPSY.Lab-VR, Department of Human Sciences, University of Verona, Verona, Italy
Brain Connectivity and Behaviour Laboratory, Sorbonne Universities, Paris, France; Frontlab, Institut du Cerveau et de la Moelle épinière (ICM), UPMC UMRS 1127, Inserm U 1127, CNRS UMR 7225, Paris, France; Groupe d’Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives-UMR 5293, CNRS, CEA University of Bordeaux, Bordeaux, France
The syndrome of Anosognosia for Hemiplegia (AHP) can provide unique insights into the neurocognitive processes of motor awareness. Yet, prior studies have only explored predominately discreet lesions. Using advanced structural neuroimaging methods in 174 patients with a right-hemisphere stroke, we were able to identify three neural systems that contribute to AHP, when disconnected or directly damaged: the (i) premotor loop (ii) limbic system, and (iii) ventral attentional network. Our results suggest that human motor awareness is contingent on the joint contribution of these three systems.
