Maier Franziska, Prigatano George P
Department of Neurology, University of Marburg, Marburg, Germany.
Klinik und Poliklinik für Neurologie, Universitätsklinikum Köln (AöR), Cologne, Germany.
Arch Clin Neuropsychol. 2017 Nov 1;32(7):802-809. doi: 10.1093/arclin/acx094.
Traditionally, anosognosia for cognitive or motor impairments in patients with Parkinson's disease (PD) was viewed as unlikely unless the patient was demented. More recent research has suggested that a portion of non-demented PD patients (30%-50%) in fact have impaired subjective awareness (ISA) of their motor impairments (ISAm). This empirical finding has implications for the clinical neuropsychological examination of PD patients and raises theoretical questions relevant to the broader study of anosognosia seen in other patient groups. The purpose of this paper is to primarily review our own research in this area and to summarize research findings of other investigators who have examined ISA in PD patients. Our secondary goal is to demonstrate the relevance of assessing ISA when conducting a neuropsychological examination of PD patients. Our findings suggest ISAm in PD patients is related to motor signs of right hemispheric dysfunction, but the brain imaging correlates of ISA for hypokinesias appear different than those obtained for ISA for dyskinesia in this patient group.
传统上，帕金森病（PD）患者若存在认知或运动障碍，除非患者患有痴呆，否则不太可能出现失认症。最近的研究表明，一部分非痴呆型PD患者（30%-50%）实际上对其运动障碍（ISAm）的主观意识受损（ISA）。这一实证发现对PD患者的临床神经心理学检查具有启示意义，并提出了与其他患者群体中失认症更广泛研究相关的理论问题。本文的目的主要是回顾我们自己在该领域的研究，并总结其他研究人员对PD患者ISA进行研究的结果。我们的次要目标是证明在对PD患者进行神经心理学检查时评估ISA的相关性。我们的研究结果表明，PD患者的ISAm与右半球功能障碍的运动体征有关，但该患者群体中运动迟缓的ISA与运动障碍的ISA的脑成像相关性似乎不同。
