Negotiating Reality: Studying Neurons In Denial :: Biology Essays Research Papers

In comparing the articles I read to research this paper, I noticed a distinct dichotomy between the ways in which the phenomena known as anosognosia was approached, a kind of binary: psychological versus neurological. The former seem to me, though not quite magic, to have that same hint of abstraction, whereas the latter are much more functional and conceptually conceivable...that is, they are hypotheses which are solidly rooted in the neurobiology of the brain, hypotheses which are falsifiable and, therefore, more salient than those which make obscure references to unknown and unobservable psychological processes. The implications which neurobiological hypotheses, if shown to be accurate, would have are many; before exploring them, however, I shall first discuss this "denial of illness," (3) which is in itself fascinating. Anosognosia is a disorder occurring in about 5% of patients who have had a stroke affecting the right side of their brain (6), in particular the right parietal cortex, causing left hemiplegia (paralysis of the side of the body opposite to the affected side of the brain). Its characteristic feature is the inability, or, some would say, unwillingness of patients to perceive their own paralysis, and in extreme cases, that of others. It is important to note that anosognosia occurs only when the right side of the brain is involved; the effects of damage to the left hemisphere are, as shall be explained later, quite different (1). Dr. Vilayanur Ramachandran of UC San Diego has made anosognosia one of his primary foci of research and has proposed intriguing, neurological hypotheses as to what might be going on in anosognosiacs' brains. In his research, he has found that anosognosiacs do not deny paralysis merely because their brain damage causes them to be inattentive to the left side of their body; when attention is drawn to a paralyzed limb, by asking patients to perform simple motor tasks, for example, anosognosiacs will either assert that they are indeed carrying it out (when they obviously are not) (1,2,4,5,6) or make up stories to explain it away, claiming, for example, that their arthritis is acting up and that they therefore don't feel like doing it (1,2). In many cases, patients refuse to recognize the paralyzed limb as their own, accepting the bizarre and irrational implications such a statement brings with it (e.g., the limb belonging to a relative, their doctor having three arms) as quite normal (1) .