Nimmo-Smith I, Marcel A J, Tegnér R
MRC Cognition and Brain Sciences Unit, 15 Chaucer Road, Cambridge CB2 2EF, UK.
J Neurol Neurosurg Psychiatry. 2005 Aug;76(8):1167-9. doi: 10.1136/jnnp.2004.053744.
Anosognosia for hemiplegia (AHP) is conventionally defined/diagnosed by generic questions about awareness of limb plegia. However, unawareness of inability to perform tasks requiring bilateral use of limbs is more widespread and outlasts generic unawareness of plegia. Some patients consistently overestimate bilateral task ability. Our aim was to assess how well specific questions about bilateral task ability predict whether patients consistently overestimate their abilities. Six statistical indices were calculated to rank the questions for predictiveness of consistency of overestimation of bilateral task ability. Overall, bimanual questions are better predictors than bipedal questions of consistent overestimation. Three bimanual and two bipedal questions had both sensitivity and specificity above 80%. On the basis of accuracy and discriminability, one bimanual and one bipedal question that performed maximally could be used for a quick bedside heuristic index. For a more thorough diagnostic, especially for research, five bimanual and two bipedal questions were good predictors, and should be used. For both purposes, such tests should be given in combination with conventional generic questions assessing awareness of limb plegia, since the two kinds of question reflect different kinds of unawareness of motor incapacity.
偏瘫失认症（AHP）传统上是通过关于肢体瘫痪意识的一般性问题来定义/诊断的。然而，对需要双侧肢体配合完成任务的能力缺乏认知更为普遍，且持续时间超过对瘫痪的一般性认知缺乏。一些患者始终高估自己双侧任务的能力。我们的目的是评估关于双侧任务能力的特定问题在预测患者是否始终高估自身能力方面的效果如何。计算了六个统计指标，以便对双侧任务能力高估一致性的预测性问题进行排序。总体而言，对于持续高估，双手任务问题比双足任务问题具有更好的预测性。三个双手任务问题和两个双足任务问题的敏感度和特异度均高于80%。基于准确性和辨别力，一个表现最佳的双手任务问题和一个双足任务问题可用于构建快速床边启发式指标。为了进行更全面的诊断，尤其是用于研究时，五个双手任务问题和两个双足任务问题是很好的预测指标，应该使用。出于这两个目的，此类测试都应与评估肢体瘫痪意识的传统一般性问题结合使用，因为这两类问题反映了对运动能力丧失的不同类型的认知缺乏。
