Anosognosia and the Determinants of Self-Awareness

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Neuropsychology".

Deadline for manuscript submissions: closed (25 May 2025) | Viewed by 1279

Special Issue Editor


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Guest Editor
Institute of Neurology, Catholic University of the Sacred Heart, 20123 Rome, Italy
Interests: laterality of emotions; neuropsychology of dementia; unilateral spatial neglect; category-specific semantic disorders; verbal and non-verbal semantic representations; familiar people recognition disorders; anosognosia
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Special Issue Information

Dear Colleagues,

I was invited by Brain Sciences to serve as a Guest Editor for a Special Issue of the journal devoted to Anosognosia and the Determinants of Self-Awareness. I accepted this invitation with pleasure because I think that anosognosia remains one of the most complex and intriguing disorders observed in patients with brain damage. Some reasons behind this complexity include, but are not limited to, the following:

  1. The term anosognosia (lack of disease awareness) seems to indicate a unitary phenomenon, but all authors acknowledge that this term denotes several selective defects, because patients can be unaware of some deficits but not of others. This fact seems to highlight that conscious awareness is a mechanism that is intrinsic to each brain function and can be influenced by different (neurophysiological, psychological, and social) factors in different forms of anosognosia.
  2. Anosognosia (of hemiplegia) is the first defect attributed by Babinsky (more than one century ago) to a lesion of the right hemisphere, but the relations between anosognosia and right hemisphere lesions are still controversial.
  3. Anosognosia is not only important because it allows us to understand the brain mechanisms underlying conscious awareness, but also because it has a negative impact on the recovery and rehabilitation processes.

For all of these reasons, and in consideration of the excellent contributions that you have already provided to this area of research, I would really be very pleased if you could participate in this project.

Prof. Dr. Guido Gainotti
Guest Editor

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Keywords

  • anosognosia
  • disease unawareness
  • stroke patients
  • Alzheimer’s disease
  • self-awareness
  • hemiplegia
  • unilateral neglect
  • Anton syndrome
  • insight

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Published Papers (2 papers)

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Research

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17 pages, 923 KiB  
Article
Defective Awareness of Person-Recognition Disorders Through Face, Voice and Name in Right and Left Variants of Semantic Dementia: A Pilot Study
by Simona Luzzi, Oscar Prata and Guido Gainotti
Brain Sci. 2025, 15(5), 504; https://doi.org/10.3390/brainsci15050504 - 15 May 2025
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Abstract
Background/Objectives: The aim of this investigation consisted of evaluating if the prevalence of anosognosia in right-brain-damaged patients is greater for tasks in which the right hemisphere plays a dominant role and if this prevalence is at least in part due to automatic [...] Read more.
Background/Objectives: The aim of this investigation consisted of evaluating if the prevalence of anosognosia in right-brain-damaged patients is greater for tasks in which the right hemisphere plays a dominant role and if this prevalence is at least in part due to automatic processing mechanisms typical of this hemisphere. Methods: We assessed defective awareness of person-recognition disorders in 14 patients with the right variant (rv-SD) and 15 with the left variant (lv-SD) of Semantic Dementia. A battery exploring person-recognition disorders through familiarity judgement of faces, voices and names was applied. In patients with pathological performance in one of these modalities, anosognosia was assessed comparing the patients’ subjective judgment to the objective result of their performance (objective evaluation) and to the subjective judgment given by an informed caregiver (external comparison). Results: In the comparison between subjective awareness and objective scores in the various person-recognition modalities, only anosognosia for face recognition disorders was significantly more frequent of in patients with rv-SD. When compared to their caregivers, subjects with rv-SD were significantly less aware than caregivers of their difficulties only on face recognition. On the contrary, patients with a lv-SD showed a greater (non-significant) trend to be unaware of their name recognition deficit. Conclusions: These data show that the prevalence of anosognosia in right-brain-damaged patients is greater for face recognition in which the right hemisphere plays a dominant role and that this prevalence is at least in part due to automatic processing mechanisms (evocation of familiarity feelings) typical of this hemisphere. Full article
(This article belongs to the Special Issue Anosognosia and the Determinants of Self-Awareness)
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Review

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16 pages, 1392 KiB  
Review
The Assessment of the Motor and Non-Motor Aspects of Anosognosia for Hemiplegia: A Historical Review
by Maddalena Beccherle, Sara Bertagnoli and Valentina Moro
Brain Sci. 2025, 15(4), 404; https://doi.org/10.3390/brainsci15040404 - 17 Apr 2025
Viewed by 483
Abstract
Anosognosia for hemiplegia is a complex, multifaceted phenomenon. Due to the various different forms in which it manifests and the few tools available to treat it, it can create difficulties for both clinicians and researchers. Since the first definition established by Babinski, a [...] Read more.
Anosognosia for hemiplegia is a complex, multifaceted phenomenon. Due to the various different forms in which it manifests and the few tools available to treat it, it can create difficulties for both clinicians and researchers. Since the first definition established by Babinski, a great deal of research has been performed and has shown that this deficit in motor awareness involves not only motor aspects but also other, non-motor dimensions. These dimensions all need to be taken into consideration during the process of diagnosis, in particular when planning a rehabilitation programme. This article reviews the main instruments currently available for the diagnosis of anosognosia for hemiplegia. After a description of the best tests to assess motor dimensions (such as explicit and implicit anosognosia, emergent awareness and awareness for daily life activities), non-motor dimensions are analysed. The literature on the subject provides ideas and tools for the evaluation of cognitive (i.e., motor imagery), emotional and social (i.e., theory of mind) aspects. Finally, the importance of differential diagnoses in relation to disorders often associated with anosognosia is discussed. Full article
(This article belongs to the Special Issue Anosognosia and the Determinants of Self-Awareness)
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