ANOSOGNOSIA AND VISUOVERBAL CONFABULATION

Objective: To examine the relationship between verbal confabulation an d anosognosia for hemiplegia (AHP). Design: We compared patients with right hemisphere lesions and AHP with a control group with right hemis phere lesions without anosognosia. Patients attempted visual identific ations of objects exposed to the left hemifield with brief (condition 1) or prolonged (condition 2) presentations. Responses were recorded a s correct, incorrect, or admission of failure to perceive. Setting: In patients at Beth Israel Medical Center, New York, NY. Patients: A cons ecutive sample of nine patients with right hemisphere infarcts who dem onstrated left hemiparesis, extrapersonal neglect, and left-sided visu al field defects. Main Outcome Measures: Rates of correct, incorrect, and admission of failure to perceive responses. Results: Patients with AHP had higher error rates (confabulations) and lower admission of fa ilure to perceive rates than nonanosognosic patients in condition 1. P atients with AHP continued to have higher error rates in condition 2. Nonanosognosic patients had higher correct rates in condition 2 than c ondition 1. Groups did not differ in degree of neglect, lesion size or location, atrophy, sensory loss, or disorientation. Conclusion: Verba l confabulation is an important determinant in anosognosia.