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Anosognosia for hemiplegia as a tripartite disconnection syndrome

  1. Valentina Pacella  Is a corresponding author
  2. Chris Foulon
  3. Paul M Jenkinson
  4. Michele Scandola
  5. Sara Bertagnoli
  6. Renato Avesani
  7. Aikaterini Fotopoulou
  8. Valentina Moro
  9. Michel Thiebaut de Schotten  Is a corresponding author
  1. Sapienza University of Rome, Italy
  2. University of Verona, Italy
  3. Sorbonne Universities, France
  4. UPMC UMRS 1127, Inserm U 1127, CNRS UMR 7225, France
  5. The University of Texas at Austin Dell Medical School, United States
  6. University of Hertfordshire, United Kingdom
  7. IRCSS Sacro Cuore-Don Calabria Hospital, Italy
  8. University College London, United Kingdom
  9. Institut des Maladies Neurodégénératives-UMR 5293, CNRS, CEA University of Bordeaux, France
Short Report
Cite this article as: eLife 2019;8:e46075 doi: 10.7554/eLife.46075
2 figures, 1 table and 2 additional files


On the top half, statistical mapping of the lesioned areas in AHP.

(a) right hemisphere (b) striatum (c) insula (d) axial sections. Pal: pallidum; Put: putamen; ALg: anterior long gyrus; PSg: posterior short gyrus; MSg: middle short gyrus; Tp: temporal pole. On the bottom half, statistical mapping of the brain disconnections in AHP. (e) right hemisphere lateral view; (f) right hemisphere medial view; (g) axial sections. TPJ: temporo-parietal junction; VPF: ventral prefrontal cortex; preSMA: pre-supplementary area; H: hippocampus; Cing: cingulum; SLF III: third (ventral) branch of the superior longitudinal fasciculus; PreSMA: pre-supplementary motor area.

Motor awareness network.

(a) right hemisphere medial view (left) right hemisphere lateral view (right); (b-c) Bayes Factors for all models, each one representing the hypothesis that the damage to grey matter structure and/or the tract disconnection is necessary to explain AHP, against the clinical/demographic model. Ins: insula; TP: temporal pole; Put: putamen; FST: fronto-striatal tract; Cing: cingulum; FAT: frontal aslant tract; SLF III: third branch of the superior longitudinal fasciculus.



Table 1
For AHP and control groups, mean and (±standard deviation) of demographic and clinical variables, neurological and neuropsychological assessments are reported.
(N = 95)
(N = 79)
Demographic and clinical
Age (years)68.48 ± 12.5463,01 ± 13.49
Education (years)9.46 ± 3.7411 ± 3.77
Interval (days)35.74 ± 40.5844.42 ± 46.7
Lesion Size (voxels)134327.74 ± 113196.17113082.73 ± 120844.22
Bisiach score2.46 ± 0.60 ± 0
Personal neglect
Comb(leftrightstrokesleft+ambiguous+rightstrokes)−0.3 ± 0.4−0.06 ± 0.47
Extra-personal neglect
Line cancellation (number of items cancelled)19.26 ± 11.928.35 ± 10.77
Memory Span
Digit/verbal span (number of items recalled)5.65 ± 2.146.83 ± 2.46
Motor index
MRC (LUL)0.15 ± 0.420.6 ± 0.99

Data availability

The raw data used for this research (lesions) as well as the dependent variable and covariates are provided in full as Source data.

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