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Medicine Mar 2018Verbal auditory agnosia is the selective inability to recognize verbal sounds. Patients with this disorder lose the ability to understand language, write from dictation,...
RATIONALE
Verbal auditory agnosia is the selective inability to recognize verbal sounds. Patients with this disorder lose the ability to understand language, write from dictation, and repeat words with reserved ability to identify nonverbal sounds. However, to the best of our knowledge, there was no report about verbal auditory agnosia in adult patient with traumatic brain injury.
PATIENT CONCERNS
He was able to clearly distinguish between language and nonverbal sounds, and he did not have any difficulty in identifying the environmental sounds. However, he did not follow oral commands and could not repeat and dictate words. On the other hand, he had fluent and comprehensible speech, and was able to read and understand written words and sentences.
DIAGNOSIS
Verbal auditory agnosia INTERVENTION:: He received speech therapy and cognitive rehabilitation during his hospitalization, and he practiced understanding of verbal language by providing written sentences together.
OUTCOMES
Two months after hospitalization, he regained his ability to understand some verbal words. Six months after hospitalization, his ability to understand verbal language was improved to an understandable level when speaking slowly in front of his eyes, but his comprehension of verbal sound language was still word level, not sentence level.
LESSONS
This case gives us the lesson that the evaluation of auditory functions as well as cognition and language functions important for accurate diagnosis and appropriate treatment, because the verbal auditory agnosia tends to be easily misdiagnosed as hearing impairment, cognitive dysfunction and sensory aphasia.
Topics: Aged; Agnosia; Brain Injuries, Traumatic; Diagnosis, Differential; Diagnostic Errors; Humans; Male; Speech Therapy; Treatment Outcome; Verbal Behavior
PubMed: 29538212
DOI: 10.1097/MD.0000000000010136 -
Journal of Huntington's Disease 2014People with Huntington's disease (HD) may show reduced awareness of physical and mental changes in themselves. This article reviews the evidence for loss of awareness... (Review)
Review
People with Huntington's disease (HD) may show reduced awareness of physical and mental changes in themselves. This article reviews the evidence for loss of awareness (anosognosia) in an attempt to elucidate its characteristics and possible underlying mechanisms. It is shown that defective awareness occurs across domains. People with HD may under-report the presence or severity of involuntary movements, under-estimate cognitive impairment and deny behavioural change. Nevertheless, awareness is not all or none. Moreover, it may be affected differentially for different symptom domains and emerge at different stages of disease, raising the possibility of distinct contributory mechanisms. Findings of an inverse relationship between insight and severity of disease suggest that cognitive impairment, in particular executive dysfunction, may be an important contributory factor. Evidence has accrued to support this argument. However, cognitive impairment cannot fully account for patients' lack of awareness of involuntary movements. Findings that patients accurately report consequences but not the experience of involuntary movements, and better acknowledge their presence when watching videotapes of themselves suggests that physiological factors play an important role. The putative role of denial as a coping mechanism is discussed. Recognition by clinicians of deficient self-awareness is crucial because of its implications for diagnosis and optimal clinical management of HD.
Topics: Agnosia; Awareness; Humans; Huntington Disease
PubMed: 25062855
DOI: 10.3233/JHD-140109 -
Brain and Cognition Apr 2019The neural mechanisms underlying the access to object knowledge from early representations of shape are little known. Functional imaging studies support the view that...
The neural mechanisms underlying the access to object knowledge from early representations of shape are little known. Functional imaging studies support the view that representations of visual properties are distributed across occipito-temporal cortex of both cerebral hemispheres. By contrast, brain lesion studies show that focal occipito-temporal damage may lead to object agnosia - a specific impairment of object recognition. How does distributed processing fit with functional specialization implied by the existence of stimulus-specific agnosias? Using fMRI we studied functional connectivity (FC) in a patient with object agnosia following left lateral occipital damage. Despite intact global and local processing of 2D and 3D object structure, the patient made consistent object identification errors. Seven experiments testing naming, visual matching or object priming showed that his errors mainly reflected the global shape similarity between objects. Compared to controls the patient exhibited strongly reduced FC between the damaged left and the intact right medial/lateral occipital cortex. In addition, controls showed stronger connectivity between the right occipital cortex and the left and right inferior and anterior temporal cortices. Interestingly, the patient also showed compensatory increases of FC between dorsal occipital and medial parietal cortex. These findings show that focal damage to the lateral occipital cortex may have global effects on representations of objects in bilateral occipito-temporal cortex, thus supporting the view that bilaterally distributed coding is necessary for the retrieval of associative knowledge from shape.
Topics: Aged; Agnosia; Brain Mapping; Humans; Magnetic Resonance Imaging; Male; Occipital Lobe; Pattern Recognition, Visual; Visual Pathways; Visual Perception
PubMed: 30591372
DOI: 10.1016/j.bandc.2018.12.007 -
Developmental Medicine and Child... Oct 1988
Topics: Agnosia; Auditory Pathways; Humans; Language Disorders; Magnetic Resonance Imaging; Male; Radiography; Speech Disorders
PubMed: 3229568
DOI: 10.1111/j.1469-8749.1988.tb04811.x -
Consciousness and Cognition Dec 2009This paper reviews the literature concerning the neural correlates of the self, the relationship between self and memory and the profile of memory impairments in... (Review)
Review
This paper reviews the literature concerning the neural correlates of the self, the relationship between self and memory and the profile of memory impairments in Alzheimer's disease (AD) and explores the relationship between the preservation of the self and anosognosia in this condition. It concludes that a potential explanation for anosognosia in AD is a lack of updating of personal information due to the memory impairments characteristic of this disease. We put forward the hypothesis that anosognosia is due in part to the "petrified self."
Topics: Agnosia; Alzheimer Disease; Awareness; Brain; Brain Mapping; Consciousness; Denial, Psychological; Ego; Humans; Mental Recall; Nerve Net; Retention, Psychology
PubMed: 19683461
DOI: 10.1016/j.concog.2009.07.005 -
Clinical Neurology and Neurosurgery May 1996A patient of posterior cortical atrophy characterized by early signs of progressive visual agnosia documented by repeated neuropsychological tests, is reported. SPECT...
A patient of posterior cortical atrophy characterized by early signs of progressive visual agnosia documented by repeated neuropsychological tests, is reported. SPECT and MRI findings showed left unilateral parieto-occipital involvement in the earlier stage. A PET study executed eight months later showed bilateral parieto-occipital hypometabolism, but predominantly in the left hemisphere. This suggests that the degeneration may have developed asymmetrically, progressing from left unilateral to bilateral.
Topics: Agnosia; Atrophy; Cerebral Cortex; Humans; Male; Middle Aged; Neuropsychological Tests; Occipital Lobe; Parietal Lobe; Tomography, Emission-Computed, Single-Photon; Visual Perception
PubMed: 8836594
DOI: 10.1016/0303-8467(95)00091-7 -
Geriatrie Et Psychologie... Mar 2023Impaired awareness increases dependency of patients suffering from Alzheimer's Disease (AD) and caregivers' burden but remains insufficiently evaluated in clinical...
Impaired awareness increases dependency of patients suffering from Alzheimer's Disease (AD) and caregivers' burden but remains insufficiently evaluated in clinical practice. The numerous conceptualisations of this symptomatology (anosognosia, denial, insight…) have only a slight impact on the three main assessment methodologies which are: the patient-caregiver discrepancy; the clinician rating of patients' awareness of illness; and the prediction of performance discrepancy methods. Nevertheless, most of evaluating tools are not validated yet, in particular regarding the clinician rating, leading to contrasted results. Most of recent studies reported positive correlations with apathy and AD severity, and negative relationships with depressive symptoms. Therefore, impaired awareness seems to be mainly influenced by patient's depression and apathy. We discuss these correlates and shared aspects of apathy and impaired awareness from neuroanatomical, clinical and conceptual viewpoints. We also highlight the relevance and limits of quantitative and qualitative assessment methods, in particular phenomenological.
Topics: Humans; Alzheimer Disease; Depression; Neuropsychological Tests; Caregivers; Agnosia
PubMed: 37115686
DOI: 10.1684/pnv.2023.1080 -
Archives of Clinical Neuropsychology :... Nov 2017Traditionally, anosognosia for cognitive or motor impairments in patients with Parkinson's disease (PD) was viewed as unlikely unless the patient was demented. More... (Review)
Review
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.
Topics: Agnosia; Awareness; Humans; Neuropsychological Tests; Parkinson Disease
PubMed: 29028874
DOI: 10.1093/arclin/acx094 -
Current Opinion in Neurology Dec 2009This review considers recent findings on classical forms of anosognosia and less dramatic disturbances in self-awareness observed in various brain disorders. It also... (Review)
Review
PURPOSE OF REVIEW
This review considers recent findings on classical forms of anosognosia and less dramatic disturbances in self-awareness observed in various brain disorders. It also addresses issues of clinical management and ethical treatment.
RECENT FINDINGS
The study of anosognosia for hemiplegia, Anton's syndrome, and less dramatic disturbances in self-awareness in conditions such as Alzheimer's disease, mild cognitive impairment, and severe traumatic brain injury suggests its 'multifactorial' nature. Lesions in various regions of the brain may contribute to different forms of anosognosia. Animal and human studies suggest that the insular cortex plays an important role in subjective awareness of feeling states, and may be implicated in various forms of anosognosia. Also, right frontal lobe lesions have been implicated, but typically in patients who have bilateral cerebral dysfunction. These patients require careful clinical management in light of their reduced awareness of their neurological and neuropsychological functions that impact daily activities.
SUMMARY
The study of anosognosia and disorders of self-awareness has expanded greatly over the past 20 years. Various patient groups may show different levels of impaired awareness or anosognosia. Guidelines for the clinical management and ethical treatment of these patients are needed, but beginning efforts have been made.
Topics: Agnosia; Animals; Awareness; Brain; Brain Diseases; Ethics; Humans; Self Concept
PubMed: 19809315
DOI: 10.1097/WCO.0b013e328332a1e7 -
Revista de NeurologiaWe review the definition of the amusias and the cultural components involved in musical experience. We review the characteristics of musical language, perception and... (Review)
Review
INTRODUCTION
We review the definition of the amusias and the cultural components involved in musical experience. We review the characteristics of musical language, perception and performance of it together with reading and writing it.
DEVELOPMENT
We analyze the above data and significant clinical cases. We discuss whether in evaluation of the amusias it may be relevant to have had been taught music, since in this condition the functional specialization of the cerebral cortex has different topography of the lesions in persons who have or have not had musical education.
CONCLUSIONS
We consider that in persons who have studied musical language, amusia should be evaluated as a second language, and its pathology as aphasia for musical language. In persons without musical education the dysperceptive amusias are a purely agnostic phenomenon with neuropsyschological characteristics which are different to those seen in persons who have had an education in music.
Topics: Agnosia; Humans; Music
PubMed: 11426409
DOI: No ID Found