Anosodiaphoria
From Wikipedia, the free encyclopedia
Anosodiaphoria is the inability to recognize the full importance of a neurological disability brought on by a brain lesion.[1] It might be specifically associated with defective functioning of the frontal lobe of the right hemisphere.[2]
Joseph Babinski first used the term anosodiaphoria in 1914 to describe a disorder of the body schema in which patients verbally acknowledge a clinical problem (such as hemiparesis) but fail to be concerned about it.[3] Anosodiaphoria follows a stage of anosognosia, in which there may be verbal, explicit denial of the illness, and after several days to weeks, develop the lack of emotional response.[4]
Causes
A few possible explanations for anosodiaphoria exist:
- The patient is aware of the deficit but does not fully comprehend it or its significance for functioning
- May be related to an affective communication disorder and defective arousal. These emotional disorders cannot account for the verbal explicit denial of illness of anosognosia.[3]
Other explanations include reduced emotional experience, impaired emotional communication, alexithymia, behavioral abnormalities, dysexecutive syndrome, and the frontal lobes.[4]
Neurology
Anosodiaphoria occurs after stroke of the brain. 27% of patients with an acute hemispheric stroke had the stroke in the right hemisphere, while 2% have it in their left.[5]
The frontal lobe is thought to be the primary area for the lack of emotional insight seen in anosodiaphoria, such as in frontotemporal dementia. A 2011 study done by Mendez and Shapira found that people with frontotemporal dementia also had a loss of insight more properly described as "frontal anosodiaphoria", a lack of concern for proper self-appraisal. Patients were found to have a lack of emotional updating, or concern for having an illness; an absence of an emotional self-referent tagging of information on their disorder, which they think is possibly from disease in the ventromedial prefrontal cortex, anterior cingulate-anterior insula area, especially on the right.[6]