A Critical Review of Alien Limb-Related Phenomena and Implications for Functional Magnetic Resonance Imaging Studies

Frontiers in Neurology

Martina Di Pietro¹  Fedele Dono¹  Astrid Thomas¹  Laura Bonanni¹  Claudia Carrarini¹  Stefano L. Sensi¹  Mirella Russo¹  Vincenzo Di Stefano²  Raffaella Franciotti³  Roberta Telese⁴  Marco Onofrj⁵ 

[1] Center for Advanced Studies and Technology (CAST), “G. D'Annunzio” University, Chieti, Italy;Department of Biomedicine, Neuroscience and Advanced Diagnostic (BiND), University of Palermo, Palermo, Italy;Department of Neuroscience, Imaging and Clinical Sciences, “G. D'Annunzio” University of Chieti-Pescara, Chieti, Italy;IRCCS C. Mondino Foundation, Pavia, Italy;YDA Foundation, Institute of Immune Therapy and Advanced Biological Treatment, Pescara, Italy;

关键词: alien hand;    alien limb;    neurodegeneration;    corticobasal syndrome;    diagonistic dyspraxia;   

DOI  :  10.3389/fneur.2021.661130

来源: DOAJ

【 摘 要 】

Consensus criteria on corticobasal degeneration (CBD) include alien limb (AL) phenomena. However, the gist of the behavioral features of AL is still “a matter of debate.” CBD-related AL has so far included the description of involuntary movements, frontal release phenomena (frontal AL), or asomatognosia (posterior or “real” AL). In this context, the most frequent symptoms are language and praxis deficits and cortical sensory misperception. However, asomatognosia requires, by definition, intact perception and cognition. Thus, to make a proper diagnosis of AL in the context of CBD, cognitive and language dysfunctions must be carefully verified and objectively assessed. We reviewed the current literature on AL in CBD and now propose that the generic use of the term AL should be avoided. This catchall AL term should instead be deconstructed. We propose that the term AL is appropriate to describe clinical features associated with specific brain lesions. More discrete sets of regionally bound clinical signs that depend on dysfunctions of specific brain areas need to be assessed and presented when posing the diagnosis. Thus, in our opinion, the AL term should be employed in association with precise descriptions of the accompanying involuntary movements, sensory misperceptions, agnosia-asomatognosia contents, and the presence of utilization behavior. The review also offers an overview of functional magnetic resonance imaging-based studies evaluating AL-related phenomena. In addition, we provide a complementary set of video clips depicting CBD-related involuntary movements that should not mistakenly be interpreted as signs of AL.

【 授权许可】

Unknown