NPSY.Lab-VR, Department of Human Sciences, University of Verona, Verona, Italy.
Department of Psychology, School of Human and Community Development, University of Witwatersrand, Johannesburg, South Africa.
J Clin Exp Neuropsychol. 2021 Feb;43(1):91-104. doi: 10.1080/13803395.2021.1876842. Epub 2021 Feb 15.
: Anosognosia for hemiplegia (AHP) is a condition in which patients with paralysis are unaware of their motor deficits. Research into AHP is important for improving its treatment and providing insight into the neurocognitive mechanism of motor awareness. Unfortunately, most studies use assessments with widely recognized limitations. The study aims at developing a psychometrically validated assessment of AHP. : We developed a 40-item Motor Unawareness Assessment (MUNA) and administered it to 131 right-hemisphere stroke patients. Principal Component Analysis (PCA) was used to identify the underlying factor structure. Receiver Operating Characteristics (ROC) analysis was used to determine diagnostic cutoffs, and Area Under the Curve (AUC) analysis used to assess these cutoffs. Relationships with demographic, clinical and neuropsychological variables were explored. : Five factors were identified: explicit motor awareness, implicit motor awareness, impaired sense of ownership, agency and illusory movement, and emotional reactions. Established cutoffs had excellent sensitivity and specificity. Clinical, neuropsychological and demographic variables did not predict overall MUNA score but were related to specific subcomponents. : The MUNA can differentiate various facets of AHP and provides a detailed profile of (un)awareness. The MUNA can therefore provide robust assessment for research purposes and assist clinicians when developing targeted rehabilitation.
偏瘫失认症（AHP）是一种患者对瘫痪导致的运动缺陷没有认知的状况。对 AHP 的研究对于改善其治疗方法和深入了解运动意识的神经认知机制很重要。不幸的是，大多数研究使用的评估方法都存在公认的局限性。本研究旨在开发一种具有心理测量学效度的 AHP 评估方法。
我们开发了一个包含 40 个项目的运动失认评估量表（MUNA），并对 131 名右脑卒中患者进行了评估。主成分分析（PCA）用于确定潜在的因子结构。接收者操作特征（ROC）分析用于确定诊断截断值，曲线下面积（AUC）分析用于评估这些截断值。同时还探讨了与人口统计学、临床和神经心理学变量的关系。
明确的运动意识、内隐的运动意识、受损的所有权意识、agency 意识和虚幻运动意识，以及情绪反应。已确定的截断值具有良好的敏感性和特异性。临床、神经心理学和人口统计学变量不能预测总体 MUNA 评分，但与特定的子成分有关。
MUNA 可以区分 AHP 的各个方面，并提供（无意识）的详细概况。因此，MUNA 可以为研究目的提供可靠的评估，并在制定有针对性的康复治疗方案时为临床医生提供帮助。
