Agraphesthesia

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Agraphesthesia is a disorder of directional cutaneous kinesthesia or a disorientation of the skin's sensation across its space. It is a difficulty recognizing a written number or letter traced on the skin after parietal damage.

Contents

Causes

Agraphesthesia, or the lack of graphesthesia ability, results from brain damage, particularly to the parietal lobe, thalamus, and secondary somatosensory cortex. [1]

A significant relationship has been found between agraphesthesia and people living with Alzheimer's disease. Alzheimer's patients typically experience the lack of sensation in both their dominant and non-dominant hands. [2] Astereognosis, the inability to identify a physical object solely by touch, is commonly found in conjunction with agraphesthesia in Alzheimer's patients. [3] Some research suggest that agraphesthesia can be used to track the cognitive decline in Alzheimer's patients once the disease is diagnosed. [3]

Studies also show that patients diagnosed with schizophrenia and their immediate relatives have a decreased ability to perform graphesthesia tasks in comparison to people without relatives diagnosed with schizophrenia. Therefore, researchers have suggested that somatosensory dysfunction in the parietal cortex is a potential cause of graphesthesia impairments. [4]

Diagnosis

A diagnosis of agraphesthesia is determined using a variety of tests, such as the Palm Writing subtest. The Palm Writing subtest involves a series of trials where patients are asked to identify whether an X or an O was written on the palm of their hand. [2] Just as numbers and shapes may be used in addition to letters, similar neurological tests can be carried out on other parts of the body, such as the forearm and the abdomen. [5] For tests of graphesthesia like the Palm Writing subtest, it is important that subjects do not see what is being traced on their palm because this can bias the subjects' responses. [6] Subjects can be blindfolded or a screen can be used to obstruct the subject's view of the area being tested.

Notes

  1. Davis 2010, p. 263.
  2. 1 2 Davis 2010, p. 264.
  3. 1 2 Davis 2010, p. 265.
  4. Chang 2004, p. 330-331.
  5. Morch 2010, p. 46.
  6. Chang 2004, p. 330.

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The parietal lobe is one of the four major lobes of the cerebral cortex in the brain of mammals. The parietal lobe is positioned above the temporal lobe and behind the frontal lobe and central sulcus.

Astereognosis is the inability to identify an object by active touch of the hands without other sensory input, such as visual or sensory information. An individual with astereognosis is unable to identify objects by handling them, despite intact elementary tactile, proprioceptive, and thermal sensation. With the absence of vision, an individual with astereognosis is unable to identify what is placed in their hand based on cues such as texture, size, spatial properties, and temperature. As opposed to agnosia, when the object is observed visually, one should be able to successfully identify the object.

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Amorphosynthesis, also called a hemi-sensory deficit, is a neuropsychological condition in which a patient experiences unilateral inattention to sensory input. This phenomenon is frequently associated with damage to the right cerebral hemisphere resulting in severe sensory deficits that are observed on the contralesional (left) side of the body. A right-sided deficit is less commonly observed and the effects are reported to be temporary and minor. Evidence suggests that the right cerebral hemisphere has a dominant role in attention and awareness to somatic sensations through ipsilateral and contralateral stimulation. In contrast, the left cerebral hemisphere is activated only by contralateral stimuli. Thus, the left and right cerebral hemispheres exhibit redundant processing to the right-side of the body and a lesion to the left cerebral hemisphere can be compensated by the ipsiversive processes of the right cerebral hemisphere. For this reason, right-sided amorphosynthesis is less often observed and is generally associated with bilateral lesions.

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References