From the Guidelines
Asomatognosia is a complex neurological disorder that requires a multifaceted approach to management, focusing on rehabilitation strategies such as mirror therapy, visual feedback techniques, and cognitive exercises to improve awareness and recognition of affected body parts, as supported by the most recent guidelines 1.
Key Considerations
- Asomatognosia typically affects one side of the body, usually the left side, and occurs due to damage to the right parietal lobe of the brain.
- Patients with asomatognosia may deny ownership of their limbs or fail to recognize them as their own, sometimes attributing them to someone else.
- The condition commonly results from stroke, traumatic brain injury, brain tumors, or neurodegenerative diseases affecting the parietal cortex.
Treatment Approach
- Treatment focuses on addressing the underlying cause and implementing rehabilitation strategies to help patients reconnect with their affected body parts.
- Physical and occupational therapy are essential components of the treatment plan to maintain function and prevent complications like muscle atrophy.
- A multifaceted approach, including top-down and bottom-up strategies, such as half-field eye patching, visual scanning training, prism adaptation, limb activation, optokinetic stimulation, mental imagery, and brain stimulation, may be effective in improving neglect symptoms, as suggested by recent studies 1.
Important Considerations
- Patients and caregivers should be educated about safety precautions to prevent injuries to the affected limbs that the patient may neglect due to lack of awareness.
- Early intervention and the extent of brain damage are crucial factors in determining the likelihood of complete recovery.
- The most recent guidelines emphasize the importance of a comprehensive approach to managing asomatognosia, incorporating rehabilitation strategies, patient education, and safety precautions to improve outcomes and quality of life 1.
From the Research
Definition and Characteristics of Asomatognosia
- Asomatognosia refers to a unilateral disturbance of body ownership following a cerebrovascular incident, where patients consider the contralesional limbs as missing or having disappeared from awareness 2.
- This neuropsychological disorder modifies body ownership in terms of perceptual experience, visual identification, and sense of belonging of contralesional body parts.
- Asomatognosia is usually tested by using verbal scales, but a new test has been developed that includes a visual identification task and a reaching task to assess this disorder 2.
Diagnosis and Assessment of Asomatognosia
- The novel task developed to assess asomatognosia involves identifying, reaching, and touching the contralesional hand when positioned in peripersonal space, in the presence of an extraneous hand 2.
- The results of this task show that asomatognosia cannot be simply considered as one of the many manifestations of personal neglect, but should be taken into account as a "productive" disorder characterized by the misidentification of the own hand with an extraneous hand 2.
- Voxel-based Lesion Symptom Mapping (VLSM) analysis has revealed the involvement of the inferior and middle frontal lobe in patients with asomatognosia 2.
Treatment and Rehabilitation of Asomatognosia
- Mirror therapy has been studied as a potential treatment for asomatognosia, as it uses visual stimuli to produce a desired response in the affected limb 3, 4.
- Mirror therapy has shown promising results in improving upper limb motor recovery and activities of daily living in stroke individuals, although the extent of improvements in sensory impairments and hemineglect is limited 3, 4.
- Occupational therapy has also been used to address depressive and anxiety symptoms in patients with physical disabilities, including those with asomatognosia, although the evidence is limited and further research is needed 5, 6.