'Moving' a paralysed hand: Bimanual coupling effect in patients with anosognosia for hemiplegia

Francesca Garbarini, Marco Rabuffetti, Alessandro Piedimonte, Lorenzo Pia, Maurizio Ferrarin, Francesca Frassinetti, Patrizia Gindri, Anna Cantagallo, Jon Driver, Anna Berti

Research output: Contribution to journalArticlepeer-review


Selective neurological impairments can shed light on different aspects of motor cognition. Brain-damaged patients with anosognosia for hemiplegia deny their motor deficit and believe they can still move the paralysed limb. Here we study, for the first time, if the anomalous subjective experience that their affected hand can still move, may have objective consequences that constrain movement execution with the opposite, intact hand. Using a bimanual motor task, in which anosognosic patients were asked to simultaneously trace out lines with their unaffected hand and circles with their paralysed hand, we found that the trajectories of the intact hand were influenced by the requested movement of the paralysed hand, with the intact hand tending to assume an oval trajectory (bimanual coupling effect). This effect was comparable to that of a group of healthy subjects who actually moved both hands. By contrast, brain-damaged patients with motor neglect or actual hemiplegia but no anosognosia did not show this bimanual constraint. We suggest that anosognosic patients may have intact motor intentionality and planning for the plegic hand. Rather than being merely an inexplicable confabulation, anosognosia for the plegic hand can produce objective constraints on what the intact hand does.

Original languageEnglish
Pages (from-to)1486-1497
Number of pages12
Issue number5
Publication statusPublished - 2012


  • action monitoring
  • anosognosia
  • brain damage
  • intention
  • interlimb coordination

ASJC Scopus subject areas

  • Clinical Neurology


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