The Neural Basis of Anosognosia for Spatial Neglect After Stroke

Abstract

Background and Purpose— The present study investigated the lesion anatomy of anosognosia for visuospatial neglect resulting from right hemispheric stroke. Methods— In 63 patients, self-ratings of performance in paper-and-pencil tests were contrasted with external performance ratings. Lesion analysis was conducted on patient subgroups with different degrees of anosognosia but comparable visuospatial impairment. Results— Independent of the severity of visuospatial neglect per se, damage to the right angular and superior temporal gyrus was associated with higher levels of anosognosia. Conclusions— Using a novel assessment of anosognosia for spatial neglect, the present study relates stroke-induced self-awareness deficits to inferior parietal and superior temporal brain damage.