Department of Neurology, University Hospital Cologne.
Neurological Rehabilitation Centre Godeshöhe.
Neuropsychology. 2018 May;32(4):509-515. doi: 10.1037/neu0000451. Epub 2018 Apr 19.
Reduced awareness for motor or cognitive impairments has mainly been studied in relation to right-hemispheric deficits such as left-sided hemiparesis. However, recent studies suggest that also left hemisphere (LH) stroke can lead to reduced awareness for neurological/neuropsychological deficits, for example, aphasia. The aim of the current study was to characterize reduced awareness for apraxic as well as aphasic deficits in patients suffering from LH stroke.
After the assessment of apraxia and aphasia, patients (n = 32) were asked to rate their performance on a 1- to 5-point rating scale. An unawareness score (UAS) was computed as the difference between the examiners' ratings and self-ratings, resulting in negative scores for patients who overestimated their performance in a given assessment, that is, exhibited reduced awareness for their stroke-related deficits.
Patients with apraxia (n = 14) and aphasia (n = 16) significantly overestimated their performance in the respective assessment. However, the level of awareness was not generally related to the severity of apraxia, and there were no group differences in other variables between patients with full (n = 7) and reduced awareness (n = 7) for apraxic deficits. The reduction of awareness for apraxic deficits did not differ significantly for buccofacial versus limb gestures.
Data show that LH stroke can lead to reduced awareness not only for aphasic deficits but also for buccofacial and limb apraxia. (PsycINFO Database Record
对运动或认知障碍的意识降低主要与右半球缺陷（如左侧偏瘫）有关。然而，最近的研究表明，左半球（LH）中风也会导致对神经/神经心理学缺陷（例如失语症）的意识降低。本研究的目的是描述 LH 中风患者对失用症和失语症缺陷的意识降低情况。
在评估失用症和失语症后，患者（n=32）被要求在 1-5 分的评分量表上对自己的表现进行评分。不了解分数（UAS）的计算方法是将评估者的评分和自我评分之间的差异，对于在给定评估中高估自己表现的患者（即对与中风相关的缺陷表现出意识降低），结果为负数。
患有失用症的患者（n=14）和失语症的患者（n=16）在各自的评估中明显高估了自己的表现。然而，意识水平与失用症的严重程度并无普遍关系，在失用症的完全意识（n=7）和部分意识（n=7）患者之间，其他变量没有组间差异。对失用症缺陷的意识降低没有因口面部与肢体动作的不同而有显著差异。
数据表明，LH 中风不仅会导致对失语症缺陷的意识降低，还会导致对口面部和肢体失用症的意识降低。
