Affiliations: Department of Psychology, University of
Milano-Bicocca, Milano, Italy | IRCCS Istituto Auxologico Italiano, Milano,
Italy | Faculty of Psychology, University of Milano-Bicocca,
Milano, Italy
Note: [] Corresponding author: Giuseppe Vallar, MD, Università
degli studi di Milano-Bicocca, Dipartimento di Psicologia, Edificio U6, Piazza
dell'Ateneo Nuovo 1 20126-Milano, Italia. E-mail: giuseppe.vallar@unimib.it
Abstract: Purpose: The syndrome of unawareness (anosognosia) for sensory and
motor neurological deficits (hemiplegia, hemianaesthesia, and hemianopia),
contralateral to the side of a hemispheric lesion, is reviewed. Content: Main topics include: basic historical facts; the types of
patient's interview and specific questions used to reveal the deficits; the
clinical patterns of presentation; the associations and dissociations of the
different anosognosic manifestations, and their relationships with associated
disorders of sensory, memory, and executive-intellectual functions; the
hemispheric asymmetry of anosognosia, that, as the syndrome of unilateral
spatial neglect, is more frequent and severe after damage to the right cerebral
hemisphere; the relationships between spatial neglect and the anosognosias, and
their neural correlates; the effects of lateralized sensory stimulations on
defective awareness of neurological impairments. Conclusions: The argument is made that anosognosia for sensory and
motor neurological deficits should be considered as a multi-component syndrome,
including a number of specific disorders that are due to the impairment of
discrete monitoring systems, specific for the different supervised functions.
The putative causal role of associated deficits of other parts of the
sensory-motor or cognitive (e.g., memory, general intelligence) system is
critically discussed. These specific control processes may be physically
implemented in brain areas anatomically (and functionally) close to those
subserving the monitored function.
