Vallar Giuseppe, Ronchi Roberta
Department of Psychology, University of Milano-Bicocca, Milano, Italy.
Restor Neurol Neurosci. 2006;24(4-6):247-57.
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.
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.
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.
对半球病变一侧对侧的感觉和运动神经功能缺损（偏瘫、偏身感觉缺失和偏盲）的失认综合征（疾病感缺失）进行综述。
主要主题包括：基本历史事实；用于揭示缺损的患者访谈类型和具体问题；临床表现模式；不同疾病感缺失表现的关联和分离，以及它们与感觉、记忆和执行-智力功能相关障碍的关系；疾病感缺失的半球不对称性，即与单侧空间忽视综合征一样，在右半球受损后更常见且更严重；空间忽视与疾病感缺失之间的关系及其神经关联；侧化感觉刺激对神经功能缺损意识缺陷的影响。
有人认为，感觉和运动神经功能缺损的疾病感缺失应被视为一种多成分综合征，包括一些由于离散监测系统受损而导致的特定障碍，这些系统针对不同的受监督功能具有特异性。对感觉运动或认知（如记忆、一般智力）系统其他部分的相关缺损的假定因果作用进行了批判性讨论。这些特定的控制过程可能在解剖学（和功能上）与执行被监测功能的脑区相近的脑区中实际实现。
