Monai Elena, Pini Lorenzo, Palacino Federica, Bisio Marta, Bernocchi Francesca, Salvalaggio Alessandro, Corbetta Maurizio
Neurological Clinic, Department of Neuroscience, University of Padua, Padua, Italy.
Padua Neuroscience Center, University of Padua, Padua, Italy.
Ann Neurol. 2023 Sep 14. doi: 10.1002/ana.26791.
Brain lesions sometimes induce a failure of recognition of one's own deficits (anosognosia). Lack of deficit awareness may underlie damage of modality-specific systems, for example, visual cortex for visual anosognosia or motor/premotor cortex for motor anosognosia. However, focal lesions induce widespread remote structural and functional disconnection, and anosognosia, independent of modality, may also involve common neural mechanisms.
Here, we study the neural correlates of Anton syndrome (AS), anosognosia of blindness, and compare them with anosognosia for hemiplegia to test whether they share different or common mechanisms. We measured both local damage and patterns of structural-functional disconnection as predicted from healthy normative atlases.
AS depends on bilateral striate and extrastriate occipital damage, and disconnection of ventral and dorsal frontoparietal regions involved in attention control. Visual and motor anosognosia each share damage of modality-specific regions, but also involve the disruption of white matter tracts, leading to functional disconnection within dorsal frontal-parietal regions that play critical roles in motor control, visuospatial attention, and multisensory integration.
These results reveal the unique shared combination of content-specific and supramodal mechanisms in anosognosia. ANN NEUROL 2023.
脑部病变有时会导致对自身缺陷的认知障碍（疾病失认症）。缺乏缺陷意识可能是特定感觉系统受损的原因，例如，视觉失认症是由于视觉皮层受损，运动失认症是由于运动/运动前皮层受损。然而，局灶性病变会导致广泛的远距离结构和功能断开连接，并且与感觉方式无关的疾病失认症也可能涉及共同的神经机制。
在此，我们研究了安东综合征（AS）（失明失认症）的神经关联，并将其与偏瘫失认症进行比较，以测试它们是否共享不同或共同的机制。我们测量了根据健康标准图谱预测的局部损伤以及结构-功能断开连接的模式。
AS取决于双侧枕叶纹状和纹状外区域的损伤，以及参与注意力控制的腹侧和背侧额顶区域的断开连接。视觉和运动失认症各自都有特定感觉区域的损伤，但也涉及白质束的破坏，导致在运动控制、视觉空间注意力和多感觉整合中起关键作用的背侧额顶区域内的功能断开连接。
这些结果揭示了疾病失认症中特定内容和超感觉方式机制的独特共同组合。《神经病学年鉴》2023年。
