Verbal intelligence in Neglect: the role of anosognosia for hemiplegia.

Aim: General intelligence of patients with neglect has been poorly investigated and data at present are contrasting. Moreover it is not yet defined whether the presence of anosognosia for hemiplegia is associated with intellectual impairment in patients with neglect.

Methods: In this prospective study the authors evaluated the verbal intelligence quotient in neglect patients. This study was carried out on 33 patients with left hemiparesis: 11 patients had neglect (group N), 11 had neglect + anosognosia (group N+A) and 11 had neither neglect nor anosognosia (control group).

Results: Patients of group neglect + anosognosia had significantly lower verbal IQ (VIQ) and mini-mental state examination (MMSE) scores than those of neglect (respectively: P=0.004 and P=0.000) and control groups (respectively: P=0.041 and P=0.000). No significant differences were detected between neglect and control groups for VIQ and MMSE. In N+A group VIQ score was lower than 90 in 81.8% and MMSE score was lower than 24 in 100% of patients. Moreover, 18.2% of N+A patients had VIQ score lower than 80 and 45.4% had MMSE score lower than 18/30. Also 9.1% of neglect group had VIQ score lower than 90 and 36.4% MMSE scores less than 24/30, but none of these patients had VIQ and MMSE scores respectively lower than 80 and 18/30. Similar data were present in control group.

Conclusions: This study focuses on mental impairment in neglect + anosognosia patients and indicates that A for hemiplegia is a condition that more often occurs when severe mental impairment is present.