Undoubtedly unaware of homonymous hemianopia: The contribution of overconfidence to anosognosia of hemianopia

• DOI: 10.1016/j.cortex.2024.03.016
• Publication Date: 2024-05-29T18:37:16Z
• Authors: Julian Klingbeil; Martin Mühlig; Emma Bahr; Florian Welle; Tim Ritter; Anika Stockert; Max Wawrzyniak; Dorothee Saur
• Keywords: Anosognosia; Stroke

A new functional deficit caused by a stroke can be understood as situation of uncertainty that has to prompt discovery and subsequent incorporation into an altered self-perception. Anosognosia for visual field deficits is frequent after stroke. For hemiplegia, patients' performance in riddle test provided evidence the inability generate adjust beliefs face contributes anosognosia hemiplegia. In this prospective study, same riddles are used patients with homonymous hemianopia due first-ever posterior cerebral artery territory age-matched control cohort. The create resolved five successive clues which progressively delimit target word. After each clue, have guess word rate their confidence answer's correctness. Patients were tested once during hospital stay. According Bisiach score anosognosia, 12 out 29 unaware deficits. All had right hemisphere lesions. without did not differ significantly global cognitive impairment, mental flexibility or memory function. Importantly, showed higher ratings than controls first two (situations uncertainty). This was demonstrated significant interaction effect mixed ANOVA factors group (anosognosia, nosognosia, controls) clues. An exploratory lesion subtraction analysis high proportion unawareness lesions fusiform (para)hippocampal gyri. Our findings suggest overconfidence situations might contribute appearance hemianopia. Because been before we supra-modal contributor unawareness.