Cognitive-functional Evaluation of Anosognosia

María Rodríguez Bailón

Status: Completed

Conditions: Brain Damage; Anosognosia

Treatments: Other: Cognitive-functional evaluation

Study type: Observational

Funder types: Other

Identifiers

NCT03712839

PSI2016-80331-P

Details and patient eligibility

About

Acquired brain damage patients usually show severe cognitive deficit that alter their performance on every day life activities. Some of them suffer anosognosia and they are not aware of their own limitations. This situation increases disability by producing a large number of unsafe behaviours, caregivers burn-out and impede rehabilitation by affecting patients desire to follow treatment instructions. From disciplines like Neuropsychology, Cognitive Neuroscience or Occupational Therapy, it is considered a crucial issue to investigate the cognitive and neural mechanisms responsible of anosognosia, as well as to increase our knowledge about the most efficient treatments to deal with this phenomenon. The main general objective of this project is to generate and validate a detailed cognitive assessment protocol within the context of ADL to evaluate the different cognitive components of consciousness proposed on the Toglia and Kirk´s model: 1) Offline componente: metacognitive knowledge and 2) Online component: emergent awareness, self-regulation, anticipatory awareness, self-evaluation and updating processes).

Full description

The proposed protocol is composed by two ecological tools: The Cog-Awareness ADL Scale (ADL scale of metacognitive knowledge) and the Basic and Instrumental ADL performance based test (Awareness ADL), to identify the presence of cognitive deficits and anosognosia in patients with ABI always within the context of everyday life activities. One first specific aim is to test the convergent validity of the two proposed ecological tools with other traditional and validated measures usually used to assess similar cognitive processes and components of self-awareness. The second specific objective is to investigate the external validity of the ecological tools, by testing whether they are able to discriminate between acquired brain damage patients with and without anosognosia and a group of neurologically healthy participants on every component.

After conducting a literature review of the subject we found that this would be the first protocol developed to identify all these components in the same study.

Enrollment: 48 patients

Sex: All

Ages: 18 to 85 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Presence of an acquired brain damage objectively observed with medical reports.
• Cognitive deficits relative to executive functions and/or memory evaluated by the team of professionals who recruit participants in the hospital.

Exclusion criteria

• Presence of a serious visuoperceptual deficit that makes it difficult to complete the ADL tasks, evaluated by the team of professionals who recruit participants in the hospital.
• Presence of an understanding deficit (aphasia) evaluated by the team of professionals who recruit participants in the hospital.
• Presence of spatial neglect evaluated with line cancellation and line bisection tests.
• Presence of motor deficits in both upper limbs that impedes to complete the ADL tasks.
• Total score in MMSE<18

Trial design

48 participants in 3 patient groups

Acquired Brain Injury group with anosognosia

Description:

People with presence of an acquired brain damage and cognitive deficits relative to executive functions and memory. To determine the presence of anosognosia, patients must present an overestimation value of their capacities greater than 5 (\>5) in the discrepancy index on the Patient Competency Rating Scale (PCRS) (Prigatano et al., 1998).

Treatment:

Other: Cognitive-functional evaluation

Acquired Brain Injury group without anosognosia

Description:

People with presence of an acquired brain damage and cognitive deficits relative to executive functions and memory. These patients must present a score of \< 5 on the PCRS Scale.

Treatment:

Other: Cognitive-functional evaluation

Control group

Description:

Healthy participants matched in age, gender and educational level with the others two groups.

Treatment:

Other: Cognitive-functional evaluation