Limb Misidentification: A Clinical-Anatomical Prospective Study

J Neuropsychiatry Clin Neurosci. 2017 Summer;29(3):284-288. doi: 10.1176/appi.neuropsych.16090169. Epub 2017 Mar 28.

Abstract

The misidentification of one's own limb (LM) after right hemisphere stroke is a striking phenomenon that is incompletely understood. The authors prospectively studied the natural history and anatomy of LM in 36 patients with hyperacute right middle cerebral artery infarct. Unlike in previous studies, rapid clinical assessment was prioritized. The authors found LM to be common and transient, involving 61% at onset, evolving to 15% at 1 week. Voxel-based lesion-symptom mapping found supramarginal gyrus (SMG) damage associated with LM. This substantiates the SMG's importance in LM and has broader implications for lesion analysis: timing matters. Rapid assessment of transient disorders minimizes false negatives, which can improve lesion analysis.

Keywords: Asomatognosia; Neglect; Neuroanatomy; Somatoparaphrenia; Stroke and Other Cerebral Vascular Disease (Neuropsychiatric Aspects).

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Aged, 80 and over
  • Brain / diagnostic imaging*
  • Brain / pathology*
  • Female
  • Hand
  • Humans
  • Infarction, Middle Cerebral Artery / complications*
  • Infarction, Middle Cerebral Artery / diagnostic imaging*
  • Infarction, Middle Cerebral Artery / epidemiology
  • Infarction, Middle Cerebral Artery / pathology
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Paresis / diagnostic imaging
  • Paresis / epidemiology
  • Paresis / etiology
  • Paresis / pathology
  • Perceptual Disorders / diagnostic imaging*
  • Perceptual Disorders / epidemiology
  • Perceptual Disorders / etiology*
  • Perceptual Disorders / pathology
  • Prevalence
  • Prospective Studies
  • Self Concept
  • Tomography, X-Ray Computed
  • Young Adult