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Anosognosia

MedGen UID:
536043
Concept ID:
C0234507
Disease or Syndrome
Synonym: Lack of insight
SNOMED CT: Anosognosia (20930002)
 
HPO: HP:0000757
Monarch Initiative: MONDO:0000663

Definition

Lack of insight (Anosognosia) is a neurological condition in which an individual is unaware of his or her own neurological deficit or psychiatric condition. Anosognosia can be associated with mental illness, dementia, and structural brain lesions and can affect an individual's conscious awareness of deficits involving judgment, emotions, memory, executive function, language skills, and motor ability. [from HPO]

Conditions with this feature

Frontotemporal dementia and/or amyotrophic lateral sclerosis 7
MedGen UID:
318833
Concept ID:
C1833296
Disease or Syndrome
CHMP2B frontotemporal dementia (CHMP2B-FTD) has been described in a single family from Denmark, in one individual with familial FTD from Belgium, and in one individual with FTD and no family history. It typically starts between ages 46 and 65 years with subtle personality changes and slowly progressive behavioral changes, dysexecutive syndrome, dyscalculia, and language disturbances. Disinhibition or loss of initiative is the most common presenting symptom. The disease progresses over a few years into profound dementia with extrapyramidal symptoms and mutism. Several individuals have developed an asymmetric akinetic rigid syndrome with arm and gait dystonia and pyramidal signs that may be related to treatment with neuroleptic drugs. Symptoms and disease course are highly variable. Disease duration may be as short as three years or longer than 20 years.
Spinocerebellar ataxia type 17
MedGen UID:
337637
Concept ID:
C1846707
Disease or Syndrome
Spinocerebellar ataxia type 17 (SCA17) is characterized by ataxia, dementia, and involuntary movements, including chorea and dystonia. Psychiatric symptoms, pyramidal signs, and rigidity are common. The age of onset ranges from three to 55 years. Individuals with full-penetrance alleles develop neurologic and/or psychiatric symptoms by age 50 years. Ataxia and psychiatric abnormalities are frequently the initial findings, followed by involuntary movement, parkinsonism, dementia, and pyramidal signs. Brain MRI shows variable atrophy of the cerebrum, brain stem, and cerebellum. The clinical features correlate with the length of the polyglutamine expansion but are not absolutely predictive of the clinical course.
Polycystic lipomembranous osteodysplasia with sclerosing leukoencephalopathy 1
MedGen UID:
1648386
Concept ID:
C4721893
Disease or Syndrome
Polycystic lipomembranous osteodysplasia with sclerosing leukoencephalopathy (PLOSL) is characterized by fractures (resulting from radiologically demonstrable polycystic osseous lesions), frontal lobe syndrome, and progressive presenile dementia beginning in the fourth decade. The clinical course of PLOSL can be divided into four stages: 1. The latent stage is characterized by normal early development. 2. The osseous stage (3rd decade of life) is characterized by pain and tenderness, mostly in ankles and feet, usually following strain or injury. Fractures are typically diagnosed several years later, most commonly in the bones of the extremities. 3. In the early neurologic stage (4th decade of life), a change of personality begins to develop insidiously. Affected individuals show a frontal lobe syndrome (loss of judgment, euphoria, loss of social inhibitions, disturbance of concentration, and lack of insight, libido, and motor persistence) leading to serious social problems. 4. The late neurologic stage is characterized by progressive dementia and loss of mobility. Death usually occurs before age 50 years.

Professional guidelines

PubMed

McCurdy MD, Turner EM, Barakat LP, Hobbie WL, Deatrick JA, Paltin I, Fisher MJ, Hocking MC
J Int Neuropsychol Soc 2016 Oct;22(9):900-910. Epub 2016 Sep 26 doi: 10.1017/S1355617716000771. PMID: 27667398
Murrey GJ, Hale FM, Williams JD
Brain Inj 2005 Aug 10;19(8):599-603. doi: 10.1080/02699050400025257. PMID: 16175813
Kaufman DM, Weinberger M, Strain JJ, Jacobs JW
Gen Hosp Psychiatry 1979 Sep;1(3):247-55. doi: 10.1016/0163-8343(79)90026-4. PMID: 499797

Recent clinical studies

Etiology

Considine CM, Hughes S, Sellers Gibson J, Isaacs D, McDonell K, Darby RR, Claassen D
Cogn Behav Neurol 2022 Mar 3;35(1):40-48. doi: 10.1097/WNN.0000000000000293. PMID: 35239598
Chapman S, Beschin N, Cosentino S, Elkind MSV, Della Sala S, Cocchini G
Neuropsychology 2019 Oct;33(7):1020-1031. Epub 2019 Jun 20 doi: 10.1037/neu0000568. PMID: 31219295
Caggiano P, Jehkonen M
Neuropsychol Rev 2018 Dec;28(4):417-435. Epub 2018 Dec 13 doi: 10.1007/s11065-018-9394-4. PMID: 30547412Free PMC Article
Vilaplana M, Richard-Devantoy S, Turecki G, Jaafari N, Jollant F
J Clin Psychiatry 2015 Mar;76(3):303-18. doi: 10.4088/JCP.14r09329. PMID: 25830450
Celesia GG, Brigell MG, Vaphiades MS
Neurology 1997 Jul;49(1):88-97. doi: 10.1212/wnl.49.1.88. PMID: 9222175

Diagnosis

Gainotti G
Front Neurol Neurosci 2019;44:75-82. Epub 2019 Apr 30 doi: 10.1159/000494954. PMID: 31220837
Caggiano P, Jehkonen M
Neuropsychol Rev 2018 Dec;28(4):417-435. Epub 2018 Dec 13 doi: 10.1007/s11065-018-9394-4. PMID: 30547412Free PMC Article
Mograbi DC, Morris RG
Cortex 2018 Jun;103:385-386. Epub 2018 Apr 12 doi: 10.1016/j.cortex.2018.04.001. PMID: 29731103
Grattan ES, Skidmore ER, Woodbury ML
OTJR (Thorofare N J) 2018 Apr;38(2):113-120. Epub 2017 Dec 18 doi: 10.1177/1539449217747586. PMID: 29251546Free PMC Article
Starkstein SE
Cortex 2014 Dec;61:64-73. doi: 10.1016/j.cortex.2014.07.019. PMID: 25481465

Therapy

Bode LKG, Sprenger A, Helmchen C, Hauptmann B, Münte TF, Machner B
Ann Phys Rehabil Med 2023 Jun;66(5):101713. Epub 2023 Jan 14 doi: 10.1016/j.rehab.2022.101713. PMID: 36645965
Toglia J, Chen P
Neuropsychol Rehabil 2022 Jun;32(5):792-813. Epub 2020 Jul 20 doi: 10.1080/09602011.2020.1790394. PMID: 32684100Free PMC Article
Barrett AM
Continuum (Minneap Minn) 2021 Dec 1;27(6):1624-1645. doi: 10.1212/CON.0000000000001076. PMID: 34881729Free PMC Article
Jenkinson PM, Edelstyn NM, Stephens R, Ellis SJ
Cogn Behav Neurol 2009 Jun;22(2):117-21. doi: 10.1097/WNN.0b013e3181a722b0. PMID: 19506428
Gilmore RL, Heilman KM, Schmidt RP, Fennell EM, Quisling R
Neurology 1992 Apr;42(4):925-7. doi: 10.1212/wnl.42.4.925. PMID: 1565254

Prognosis

Konstantakopoulos G
Psychiatriki 2019 Jan-Mar;30(1):13-16. doi: 10.22365/jpsych.2019.301.13. PMID: 31115349
Wilson RS, Sytsma J, Barnes LL, Boyle PA
Curr Neurol Neurosci Rep 2016 Sep;16(9):77. doi: 10.1007/s11910-016-0684-z. PMID: 27438597
Landi P, Marazziti D, Rutigliano G, Dell'Osso L
Harv Rev Psychiatry 2016 May-Jun;24(3):214-28. doi: 10.1097/HRP.0000000000000083. PMID: 27075815
Starkstein SE
Cortex 2014 Dec;61:64-73. doi: 10.1016/j.cortex.2014.07.019. PMID: 25481465
Orfei MD, Caltagirone C, Spalletta G
Cerebrovasc Dis 2009;27(3):280-9. Epub 2009 Feb 6 doi: 10.1159/000199466. PMID: 19202333

Clinical prediction guides

de Haan EHF, Scholte HS, Pinto Y, Foschi N, Polonara G, Fabri M
J Neuropsychol 2021 Mar;15(1):1-19. Epub 2021 Feb 1 doi: 10.1111/jnp.12234. PMID: 33522716Free PMC Article
Gainotti G
Front Neurol Neurosci 2019;44:75-82. Epub 2019 Apr 30 doi: 10.1159/000494954. PMID: 31220837
Konstantakopoulos G
Psychiatriki 2019 Jan-Mar;30(1):13-16. doi: 10.22365/jpsych.2019.301.13. PMID: 31115349
Grattan ES, Skidmore ER, Woodbury ML
OTJR (Thorofare N J) 2018 Apr;38(2):113-120. Epub 2017 Dec 18 doi: 10.1177/1539449217747586. PMID: 29251546Free PMC Article
Starkstein SE
Cortex 2014 Dec;61:64-73. doi: 10.1016/j.cortex.2014.07.019. PMID: 25481465

Recent systematic reviews

Leocadi M, Canu E, Paldino A, Agosta F, Filippi M
J Neurol 2023 Apr;270(4):1880-1907. Epub 2022 Dec 13 doi: 10.1007/s00415-022-11518-9. PMID: 36512063
Calil V, Sudo FK, Santiago-Bravo G, Lima MA, Mattos P
Arq Neuropsiquiatr 2021 Apr;79(4):334-342. doi: 10.1590/0004-282X-ANP-2020-0247. PMID: 34133514Free PMC Article
Pennington C, Duncan G, Ritchie C
Int J Geriatr Psychiatry 2021 Jan;36(1):15-30. Epub 2020 Sep 14 doi: 10.1002/gps.5415. PMID: 32869379
Hallam B, Chan J, Gonzalez Costafreda S, Bhome R, Huntley J
Neurobiol Aging 2020 Oct;94:250-264. Epub 2020 Jun 18 doi: 10.1016/j.neurobiolaging.2020.06.011. PMID: 32679396Free PMC Article
Caggiano P, Jehkonen M
Neuropsychol Rev 2018 Dec;28(4):417-435. Epub 2018 Dec 13 doi: 10.1007/s11065-018-9394-4. PMID: 30547412Free PMC Article

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