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Network Localization of Awareness in Visual and Motor Anosognosia

Network Localization of Awareness in Visual and Motor Anosognosia IntroductionAnosognosia, or unawareness of a specific deficit, has been described for many brain functions, including motor and visual abilities.1–3 The most commonly reported cause of motor anosognosia, unawareness of weakness, is a right hemispheric stroke, often of the right middle cerebral artery.4,5 Some studies suggest that motor anosognosia is primarily a disconnection syndrome of premotor regions (eg, supplementary motor area) from attention/body‐monitoring regions (insula, ventral prefrontal cortex, and cingulate),6 whereas other studies suggest an additional, crucial role of memory structures, with disrupted activity in the hippocampus.1,4,7,8Much less is known about visual anosognosia, also called Anton syndrome, where there is complete cortical blindness and unawareness of vision loss.9 This disorder is almost always associated with bilateral injury to the visual cortex with the most commonly reported cause being bilateral occipital lobe infarcts, but lesion locations vary.2 Despite being described more than 100 years ago, visual anosognosia has had little formal analysis.2,10Here, we study lesion locations associated with weakness (with and without awareness) and vision loss (with and without awareness). As these 2 forms of anosognosia are in different locations, most often due to strokes in different vascular territories, lesions causing motor or visual anosognosia are less likely to directly overlap so http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Annals of Neurology Wiley

Network Localization of Awareness in Visual and Motor Anosognosia

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References (49)

Publisher
Wiley
Copyright
© 2023 American Neurological Association
ISSN
0364-5134
eISSN
1531-8249
DOI
10.1002/ana.26709
Publisher site
See Article on Publisher Site

Abstract

IntroductionAnosognosia, or unawareness of a specific deficit, has been described for many brain functions, including motor and visual abilities.1–3 The most commonly reported cause of motor anosognosia, unawareness of weakness, is a right hemispheric stroke, often of the right middle cerebral artery.4,5 Some studies suggest that motor anosognosia is primarily a disconnection syndrome of premotor regions (eg, supplementary motor area) from attention/body‐monitoring regions (insula, ventral prefrontal cortex, and cingulate),6 whereas other studies suggest an additional, crucial role of memory structures, with disrupted activity in the hippocampus.1,4,7,8Much less is known about visual anosognosia, also called Anton syndrome, where there is complete cortical blindness and unawareness of vision loss.9 This disorder is almost always associated with bilateral injury to the visual cortex with the most commonly reported cause being bilateral occipital lobe infarcts, but lesion locations vary.2 Despite being described more than 100 years ago, visual anosognosia has had little formal analysis.2,10Here, we study lesion locations associated with weakness (with and without awareness) and vision loss (with and without awareness). As these 2 forms of anosognosia are in different locations, most often due to strokes in different vascular territories, lesions causing motor or visual anosognosia are less likely to directly overlap so

Journal

Annals of NeurologyWiley

Published: Sep 1, 2023

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