Body schema and corporeal self-recognition in the alien hand syndrome

Neuropsychology. 2017 Jul;31(5):575-584. doi: 10.1037/neu0000359. Epub 2017 Apr 6.

Abstract

Objective: The alien hand syndrome (AHS) is a rare neuropsychological disorder characterized by involuntary, yet purposeful, hand movements. Patients with the AHS typically complain about a loss of agency associated with a feeling of estrangement for actions performed by the affected limb. The present study explores the integrity of the body representation in AHS, focusing on 2 main processes: multisensory integration and visual self-recognition of body parts. Three patients affected by AHS following a right-hemisphere stroke, with clinical symptoms akin to the posterior variant of AHS, were tested and their performance was compared with that of 18 age-matched healthy controls.

Method: AHS patients and controls underwent 2 experimental tasks: a same-different visual matching task for body postures, which assessed the ability of using your own body schema for encoding others' body postural changes (Experiment 1), and an explicit self-hand recognition task, which assessed the ability to visually recognize your own hands (Experiment 2).

Results: As compared to controls, all AHS patients were unable to access a reliable multisensory representation of their alien hand and use it for decoding others' postural changes; however, they could rely on an efficient multisensory representation of their intact (ipsilesional) hand. Two AHS patients also presented with a specific impairment in the visual self-recognition of their alien hand, but normal recognition of their intact hand.

Conclusion: This evidence suggests that the AHS following a right-hemisphere stroke may involve a disruption of the multisensory representation of the alien limb; instead, self-hand recognition mechanisms may be spared. (PsycINFO Database Record

MeSH terms

  • Aged
  • Alien Limb Phenomenon / etiology
  • Alien Limb Phenomenon / physiopathology*
  • Body Image
  • Female
  • Humans
  • Male
  • Middle Aged
  • Recognition, Psychology / physiology
  • Sensation Disorders / etiology
  • Sensation Disorders / physiopathology*
  • Stroke / complications*
  • Visual Perception / physiology