University of Hertfordshire

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

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The Motor Unawareness Assessment (MUNA): A new tool for the assessment of Anosognosia for hemiplegia. / Moro, Valentina; Besharati, Sahba; Scandola, Michele; Bertagnoli, Sara; Gobbetto, Valeria; Ponzo, Sonia; Bulgarelli, Cristina; Fotopoulou, Aikaterini; Jenkinson, Paul M.

In: Journal of Clinical and Experimental Neuropsychology, Vol. 43, No. 1, 15.02.2021, p. 91-104.

Research output: Contribution to journalArticlepeer-review

Harvard

Moro, V, Besharati, S, Scandola, M, Bertagnoli, S, Gobbetto, V, Ponzo, S, Bulgarelli, C, Fotopoulou, A & Jenkinson, PM 2021, 'The Motor Unawareness Assessment (MUNA): A new tool for the assessment of Anosognosia for hemiplegia', Journal of Clinical and Experimental Neuropsychology, vol. 43, no. 1, pp. 91-104. https://doi.org/10.1080/13803395.2021.1876842

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Author

Moro, Valentina ; Besharati, Sahba ; Scandola, Michele ; Bertagnoli, Sara ; Gobbetto, Valeria ; Ponzo, Sonia ; Bulgarelli, Cristina ; Fotopoulou, Aikaterini ; Jenkinson, Paul M. / The Motor Unawareness Assessment (MUNA): A new tool for the assessment of Anosognosia for hemiplegia. In: Journal of Clinical and Experimental Neuropsychology. 2021 ; Vol. 43, No. 1. pp. 91-104.

Bibtex

@article{06f922c1bfd446329e0bcd9b2f07a56c,
title = "The Motor Unawareness Assessment (MUNA): A new tool for the assessment of Anosognosia for hemiplegia",
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.",
keywords = "Anosognosia for hemiplegia, asomatognosia, bodily awareness assessment, emotions in body awareness, motor awareness",
author = "Valentina Moro and Sahba Besharati and Michele Scandola and Sara Bertagnoli and Valeria Gobbetto and Sonia Ponzo and Cristina Bulgarelli and Aikaterini Fotopoulou and Jenkinson, {Paul M}",
note = "{\textcopyright} 2021 Informa UK Limited, trading as Taylor & Francis Group. This is the accepted manuscript version of an article which has been published in final form at https://doi.org/10.1080/13803395.2021.1876842 ",
year = "2021",
month = feb,
day = "15",
doi = "10.1080/13803395.2021.1876842",
language = "English",
volume = "43",
pages = "91--104",
journal = "Journal of Clinical and Experimental Neuropsychology",
issn = "1380-3395",
publisher = "Psychology Press Ltd",
number = "1",

}

RIS

TY - JOUR

T1 - The Motor Unawareness Assessment (MUNA): A new tool for the assessment of Anosognosia for hemiplegia

AU - Moro, Valentina

AU - Besharati, Sahba

AU - Scandola, Michele

AU - Bertagnoli, Sara

AU - Gobbetto, Valeria

AU - Ponzo, Sonia

AU - Bulgarelli, Cristina

AU - Fotopoulou, Aikaterini

AU - Jenkinson, Paul M

N1 - © 2021 Informa UK Limited, trading as Taylor & Francis Group. This is the accepted manuscript version of an article which has been published in final form at https://doi.org/10.1080/13803395.2021.1876842

PY - 2021/2/15

Y1 - 2021/2/15

N2 - 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.

AB - 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.

KW - Anosognosia for hemiplegia

KW - asomatognosia

KW - bodily awareness assessment

KW - emotions in body awareness

KW - motor awareness

UR - http://www.scopus.com/inward/record.url?scp=85100882951&partnerID=8YFLogxK

U2 - 10.1080/13803395.2021.1876842

DO - 10.1080/13803395.2021.1876842

M3 - Article

C2 - 33588707

VL - 43

SP - 91

EP - 104

JO - Journal of Clinical and Experimental Neuropsychology

JF - Journal of Clinical and Experimental Neuropsychology

SN - 1380-3395

IS - 1

ER -