Examining Anosognosia of Neglect.
Emily S Grattan, Elizabeth R Skidmore, Michelle L Woodbury
PMID 29251546WHAT IT FOUND
Stroke survivors with neglect frequently lack insight into their own deficits.
Personal neglect, such as grooming or dressing, showed the highest rate of unawareness at up to 83.3%. Assessors rated neglect severity significantly higher than patients did, indicating a substantial gap in self-awareness.
Key findings
01Anosognosia of neglect was common, with the frequency of unawareness varying greatly by activity, ranging from 29.2% to 83.3%.
02Participants rated themselves as having significantly less neglect than assessors did, with a mean self-score of 5.3 compared to an assessor mean of 8.0.
03Agreement between patient and assessor ratings on specific items was poor, ranging from no agreement to fair agreement.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study combined data from two different parent studies, which may introduce heterogeneity in the sample. Participants were assessed at different time points post-stroke, although the majority (81.1%) were in the chronic stage (greater than six months post-stroke). The study did not investigate whether lesion location affects the type or severity of anosognosia. Cognitive impairment was common in the sample, but the specific relationship between cognitive deficits and anosognosia was not fully explored with a comprehensive neuropsychological battery. The CBS does not cover all daily activities, such as bathing or meal preparation, so the prevalence of anosognosia in those areas remains unknown.
Declared interests
The authors declare that there is no conflict of interest.
The easy way to misread this
Do not assume that a patient's self-report of neglect severity is accurate. The study found that participants consistently rated themselves as having less neglect than assessors observed, with poor agreement on specific items. A patient claiming they are fine during grooming or dressing may genuinely lack insight into their deficits.