Anosodiaphoria is the inability to recognize the full importance of a neurological disability brought on by a brain lesion.[1] It might be specifically associated with defective functioning of the frontal lobe of the right hemisphere.[2]
| Anosodiaphoria | |
|---|---|
| Specialty | Neurology |
Joseph Babinski first used the term anosodiaphoria in 1914 to describe a disorder of the body schema in which patients verbally acknowledge a clinical problem (such as hemiparesis) but fail to be concerned about it.[3] Anosodiaphoria follows a stage of anosognosia, in which there may be verbal, explicit denial of the illness, and after several days to weeks, develop the lack of emotional response.[4]
Signs and symptoms
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Causes
editA few possible explanations for anosodiaphoria exist:
- The patient is aware of the deficit but does not fully comprehend it or its significance for functioning
- May be related to an affective communication disorder and defective arousal. These emotional disorders cannot account for the verbal explicit denial of illness of anosognosia.[3]
Other explanations include reduced emotional experience, impaired emotional communication, alexithymia, behavioral abnormalities, dysexecutive syndrome, and the frontal lobes.[4]
Neurology
editAnosodiaphoria occurs after stroke of the brain. 27% of patients with an acute hemispheric stroke had the stroke in the right hemisphere, while 2% have it in their left.[5]
The frontal lobe is thought to be the primary area for the lack of emotional insight seen in anosodiaphoria, such as in frontotemporal dementia. A recent 2011 study done by Mendez and Shapira found that people with frontotemporal dementia also had a loss of insight more properly described at "frontal anosodiaphoria", a lack of concern for proper self-appraisal. Patients were found to have a lack of emotional updating, or concern for having an illness; an absence of an emotional self-referent tagging of information on their disorder, which they think is possibly from disease in the ventromedial prefrontal cortex, anterior cingulate-anterior insula area, especially on the right.[6]
Treatment
editIndifference to illness may have an adverse impact on a patient's engagement in neurological rehabilitation, cognitive rehabilitation and physical rehabilitation. Patients are not likely to implement rehabilitation for a condition about which they are indifferent. Although anosognosia often resolves in days to weeks after stroke, anosodiaphoria often persists.[7]
See also
editReferences
edit- ^ Mendoza, John E. (2011). "Anosodiaphoria". Encyclopedia of Clinical Neuropsychology. New York, NY: Springer New York. p. 179–179. doi:10.1007/978-0-387-79948-3_702. ISBN 978-0-387-79947-6.
- ^ Prigatano, George P. (2010-04-21). The Study of Anosognosia. Oxford University Press. ISBN 978-0-19-970244-2. Archived from the original on 2022-07-24. Retrieved 2017-08-27.
- ^ a b Prigatano, George P.; Schacter, Daniel L. (1991-01-24). Awareness of Deficit after Brain Injury: Clinical and Theoretical Issues. Oxford University Press. ISBN 978-0-19-802257-2.
- ^ a b Prigatano, G.P. (2010). The Study of Anosognosia. Oxford University Press, USA. ISBN 978-0-19-537909-9. Retrieved 2024-07-22.
- ^ STONE, S. P.; HALLIGAN, P. W.; GREENWOOD, R. J. (1993). "The Incidence of Neglect Phenomena and Related Disorders in Patients with an Acute Right or Left Hemisphere Stroke". Age and Ageing. 22 (1). Oxford University Press (OUP): 46–52. doi:10.1093/ageing/22.1.46. ISSN 0002-0729. PMID 8438666.
- ^ Mendez, Mario F.; Shapira, Jill S. (2011). "Loss of emotional insight in behavioral variant frontotemporal dementia or "frontal anosodiaphoria"". Consciousness and Cognition. 20 (4). Elsevier BV: 1690–1696. doi:10.1016/j.concog.2011.09.005. ISSN 1053-8100. PMC 3199289. PMID 21959203.
- ^ Barrett, Anna M.; Buxbaum, Laurel J.; Coslett, H. Branch; Edwards, Emmeline; Heilman, Kenneth M.; Hillis, Argye E.; Milberg, William P.; Robertson, Ian H. (2006-07-01). "Cognitive Rehabilitation Interventions for Neglect and Related Disorders: Moving from Bench to Bedside in Stroke Patients". Journal of Cognitive Neuroscience. 18 (7). MIT Press - Journals: 1223–1236. doi:10.1162/jocn.2006.18.7.1223. hdl:2262/35966. ISSN 0898-929X. PMID 16839294.