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The affective modulation of motor awareness in anosognosia for hemiplegia: behavioural and lesion evidence.

Besharati S, Forkel SJ, Kopelman M, Solms M, Jenkinson PM, Fotopoulou A - Cortex (2014)

Bottom Line: Only the negative, emotion induction condition resulted in a significant improvement of motor awareness in anosognosic patients compared to controls; the positive emotion induction did not.Additionally, the insula, putamen and anterior periventricular white matter were associated with less awareness change following the negative emotion induction.Instead, we propose an integrative account in which insular and striatal lesions result in weak interoceptive and motivational signals.

View Article: PubMed Central - PubMed

Affiliation: King's College London, Institute of Psychiatry, UK; Department of Psychology, University of Cape Town, South Africa; Clinical, Educational & Health Psychology, Division of Psychology & Language Sciences, University College London, UK. Electronic address: sahba@besharati.com.

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Voxel-based (topological) lesion-deficit analysis. A. Damaged MNI voxels predicting the severity of unawareness of symptom deficits when co-varying for lesion size (Feinberg scale, inverted, continuous measure; p < .05 for Z > 1.6449). B. Damaged MNI voxels predicting the change in awareness (differential scores, pre and post mood induction) when co-varying for lesion size (continuous measure; p < .05 for Z > 1.6449). PrC = precentral, PoC = postcentral, SMG = supramarginal, STG + superior temporal gyrus, IFG = inferior frontal gyrus, IC = internal capsule, MFG, middle frontal gyrus.
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fig4: Voxel-based (topological) lesion-deficit analysis. A. Damaged MNI voxels predicting the severity of unawareness of symptom deficits when co-varying for lesion size (Feinberg scale, inverted, continuous measure; p < .05 for Z > 1.6449). B. Damaged MNI voxels predicting the change in awareness (differential scores, pre and post mood induction) when co-varying for lesion size (continuous measure; p < .05 for Z > 1.6449). PrC = precentral, PoC = postcentral, SMG = supramarginal, STG + superior temporal gyrus, IFG = inferior frontal gyrus, IC = internal capsule, MFG, middle frontal gyrus.

Mentions: VLSM analysis using the continuous Feinberg awareness scores, revealed that voxels within the posterior insula, the supramarginal, the angular and superior temporal gyrus (SMG, AG and STG), internal capsule, pericentral gyri, and the inferior frontal gyrus (IFG) were significantly associated with differences in awareness (p < .05) (see Fig. 4A). Similar results were found when co-varying lesion size. Additionally, VLSM analysis, looking at the experimental change in awareness scores (i.e., differential scores following negative emotional induction only), without and with co-variation of lesion size, identified significant voxels (p < .05) within the anterior arm of the internal capsule, the anterior insula, the anterior lateral putamen with a lateral extension into the external capsule and an additional region in the dorsal anterior periventricular white matter (likely to contain limbic white matter connections) (see Fig. 4B).


The affective modulation of motor awareness in anosognosia for hemiplegia: behavioural and lesion evidence.

Besharati S, Forkel SJ, Kopelman M, Solms M, Jenkinson PM, Fotopoulou A - Cortex (2014)

Voxel-based (topological) lesion-deficit analysis. A. Damaged MNI voxels predicting the severity of unawareness of symptom deficits when co-varying for lesion size (Feinberg scale, inverted, continuous measure; p < .05 for Z > 1.6449). B. Damaged MNI voxels predicting the change in awareness (differential scores, pre and post mood induction) when co-varying for lesion size (continuous measure; p < .05 for Z > 1.6449). PrC = precentral, PoC = postcentral, SMG = supramarginal, STG + superior temporal gyrus, IFG = inferior frontal gyrus, IC = internal capsule, MFG, middle frontal gyrus.
© Copyright Policy - CC BY
Related In: Results  -  Collection

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Show All Figures
getmorefigures.php?uid=PMC4296216&req=5

fig4: Voxel-based (topological) lesion-deficit analysis. A. Damaged MNI voxels predicting the severity of unawareness of symptom deficits when co-varying for lesion size (Feinberg scale, inverted, continuous measure; p < .05 for Z > 1.6449). B. Damaged MNI voxels predicting the change in awareness (differential scores, pre and post mood induction) when co-varying for lesion size (continuous measure; p < .05 for Z > 1.6449). PrC = precentral, PoC = postcentral, SMG = supramarginal, STG + superior temporal gyrus, IFG = inferior frontal gyrus, IC = internal capsule, MFG, middle frontal gyrus.
Mentions: VLSM analysis using the continuous Feinberg awareness scores, revealed that voxels within the posterior insula, the supramarginal, the angular and superior temporal gyrus (SMG, AG and STG), internal capsule, pericentral gyri, and the inferior frontal gyrus (IFG) were significantly associated with differences in awareness (p < .05) (see Fig. 4A). Similar results were found when co-varying lesion size. Additionally, VLSM analysis, looking at the experimental change in awareness scores (i.e., differential scores following negative emotional induction only), without and with co-variation of lesion size, identified significant voxels (p < .05) within the anterior arm of the internal capsule, the anterior insula, the anterior lateral putamen with a lateral extension into the external capsule and an additional region in the dorsal anterior periventricular white matter (likely to contain limbic white matter connections) (see Fig. 4B).

Bottom Line: Only the negative, emotion induction condition resulted in a significant improvement of motor awareness in anosognosic patients compared to controls; the positive emotion induction did not.Additionally, the insula, putamen and anterior periventricular white matter were associated with less awareness change following the negative emotion induction.Instead, we propose an integrative account in which insular and striatal lesions result in weak interoceptive and motivational signals.

View Article: PubMed Central - PubMed

Affiliation: King's College London, Institute of Psychiatry, UK; Department of Psychology, University of Cape Town, South Africa; Clinical, Educational & Health Psychology, Division of Psychology & Language Sciences, University College London, UK. Electronic address: sahba@besharati.com.

Show MeSH
Related in: MedlinePlus