Jenkinson Paul M, Edelstyn Nicola M J, Stephens Richard, Ellis Simon J
Psychology and Mental Health, Staffordshire University, UK.
Cogn Behav Neurol. 2009 Jun;22(2):117-21. doi: 10.1097/WNN.0b013e3181a722b0.
To test the hypothesis that anosognosia for dyskinesias in Parkinson disease (PD) results from a failure to detect discrepancies between intended and actual movement.
PD patients often complain of drug-induced dyskinesias (involuntary movements) less than their carers. This remarkable unawareness is an example of anosognosia (ie, unawareness of deficits associated with an illness). A better understanding of anosognosia for dyskinesias in PD is important to understand the impact of the illness and side effects of treatment.
The ability to detect a discrepancy between intended movement and visual feedback about actual movement was investigated in 6 PD patients with anosognosia for dyskinesias, 11 nonanosognosic PD controls with dyskinesias, and 22 healthy volunteers, using a mirror to reverse the expected visual consequences of an executed movement.
Nonanosognosic PD patients and healthy volunteers rated mirror-reversed movement as significantly stranger than normal movement (P=0.024 and <0.001, respectively), whereas PD patients with anosognosia for dyskinesias did not (P=0.375).
The findings support our proposal, in that PD patients with anosognosia for dyskinesias do not report mirror-reversed movement (in which intentions and visual feedback conflict) as feeling distinct from normal movement.
检验帕金森病（PD）中运动障碍失认症是由于未能察觉预期动作与实际动作之间差异这一假说。
PD患者对药物引起的运动障碍（非自主运动）的抱怨往往少于其照料者。这种显著的无觉察是失认症（即对与疾病相关的缺陷无觉察）的一个例子。更好地理解PD中运动障碍失认症对于了解疾病的影响和治疗副作用很重要。
使用镜子来颠倒执行动作的预期视觉结果，对6名患有运动障碍失认症的PD患者、11名无运动障碍失认症的PD运动障碍对照患者和22名健康志愿者察觉预期动作与实际动作视觉反馈之间差异的能力进行了研究。
无运动障碍失认症的PD患者和健康志愿者将镜子颠倒的动作评为比正常动作明显更奇怪（分别为P = 0.024和<0.001），而患有运动障碍失认症的PD患者则没有（P = 0.375）。
研究结果支持了我们所提出的观点，即患有运动障碍失认症的PD患者不会将镜子颠倒的动作（其中意图和视觉反馈相互冲突）报告为与正常动作感觉不同。
