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The Motor Unawareness Assessment (MUNA): A new tool for the assessment of Anosognosia for hemiplegia

Moro, V; Besharati, S; Scandola, M; Bertagnoli, S; Gobbetto, V; Ponzo, S; Bulgarelli, C; ... Jenkinson, PM; + view all (2021) The Motor Unawareness Assessment (MUNA): A new tool for the assessment of Anosognosia for hemiplegia. Journal of Clinical and Experimental Neuropsychology , 43 (1) pp. 91-104. 10.1080/13803395.2021.1876842. Green open access

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Abstract

Introduction: Anosognosia for hemiplegia (AHP) is a condition in which patients with paralysis are unaware of their motor deficits. Research into AHP is important for improving its treatment and providing insight into the neurocognitive mechanism of motor awareness. Unfortunately, most studies use assessments with widely recognized limitations. The study aims at developing a psychometrically validated assessment of AHP. Method: We developed a 40-item Motor Unawareness Assessment (MUNA) and administered it to 131 right-hemisphere stroke patients. Principal Component Analysis (PCA) was used to identify the underlying factor structure. Receiver Operating Characteristics (ROC) analysis was used to determine diagnostic cutoffs, and Area Under the Curve (AUC) analysis used to assess these cutoffs. Relationships with demographic, clinical and neuropsychological variables were explored. Results: Five factors were identified: explicit motor awareness, implicit motor awareness, impaired sense of ownership, agency and illusory movement, and emotional reactions. Established cutoffs had excellent sensitivity and specificity. Clinical, neuropsychological and demographic variables did not predict overall MUNA score but were related to specific subcomponents. Conclusion: The MUNA can differentiate various facets of AHP and provides a detailed profile of (un)awareness. The MUNA can therefore provide robust assessment for research purposes and assist clinicians when developing targeted rehabilitation.

Type: Article
Title: The Motor Unawareness Assessment (MUNA): A new tool for the assessment of Anosognosia for hemiplegia
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1080/13803395.2021.1876842
Publisher version: http://doi.org/10.1080/13803395.2021.1876842
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: anosognosia for hemiplegia; motor awareness; asomatognosia; emotions in body awareness; bodily awareness assessment
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology
URI: https://discovery-pp.ucl.ac.uk/id/eprint/10123150
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