School of Psychology, University of Nottingham, University Park, Nottingham, UK.
Neuropsychologia. 2010 Oct;48(12):3443-50. doi: 10.1016/j.neuropsychologia.2010.07.027. Epub 2010 Aug 2.
The current study adds to the growing empirical research into the mechanisms underlying unawareness of paralysis following stroke (anosognosia for hemiplegia or AHP) by investigating action awareness for the non-paralysed limb in a single AHP patient. Visual feedback representing patient GG's goal-directed reaching movements was either modified by a computer or left unperturbed. Unlike healthy and brain-damaged controls, GG was unable to detect computer-generated visual perturbations as large as 20°. GG also failed to report awareness of the large on-line corrective movements that he made when compensating (often unsuccessfully) for the visual perturbations. These results suggest that the motor comparators implicated in AHP are functioning, but not at optimum levels. Moreover, because the current findings reveal a deficit in awareness for reaches with the unimpaired limb, it is suggestive of common right hemisphere networks for motor awareness in both limbs and that AHP may be a global deficit in motor awareness as opposed to a specific lack of awareness for a particular motor deficit.
当前的研究通过对单个 AHP 患者非瘫痪肢体的动作意识进行研究，为研究中风后瘫痪无知觉（偏瘫失认症或 AHP）的潜在机制提供了更多的实证研究。代表患者 GG 目标导向性伸手动作的视觉反馈要么由计算机修改，要么不受干扰。与健康人和脑损伤对照组不同，GG 无法检测到高达 20°的计算机生成的视觉干扰。当 GG 为视觉干扰进行补偿（通常是不成功的）时，他也未能报告对他进行的大型在线纠正动作的意识。这些结果表明，AHP 中涉及的运动比较器正在发挥作用，但并非处于最佳水平。此外，由于当前的发现揭示了对未受损肢体的伸展动作的意识缺失，这表明右半球的运动意识网络可能是共同的，并且 AHP 可能是运动意识的整体缺失，而不是对特定运动缺陷的特定缺乏意识。
