Preprint Case Report Version 1 Preserved in Portico This version is not peer-reviewed

The Role of White Matter Disconnection in the Symptoms Relating to the Anarchic Hand Syndrome: A Single Case Study

Version 1 : Received: 16 March 2021 / Approved: 18 March 2021 / Online: 18 March 2021 (10:09:37 CET)

A peer-reviewed article of this Preprint also exists.

Pacella, V.; Ricciardi, G.K.; Bonadiman, S.; Verzini, E.; Faraoni, F.; Scandola, M.; Moro, V. The Role of White Matter Disconnection in the Symptoms Relating to the Anarchic Hand Syndrome: A Single Case Study. Brain Sci. 2021, 11, 632. Pacella, V.; Ricciardi, G.K.; Bonadiman, S.; Verzini, E.; Faraoni, F.; Scandola, M.; Moro, V. The Role of White Matter Disconnection in the Symptoms Relating to the Anarchic Hand Syndrome: A Single Case Study. Brain Sci. 2021, 11, 632.

Journal reference: Brain Sci. 2021, 11, 632
DOI: 10.3390/brainsci11050632

Abstract

The anarchic hand syndrome refers to an inability to control the movements of one’s own hand which acts as if it had a will of its own. The symptoms may differ depending on whether the brain lesion is anterior, posterior, callosal or subcortical, but the relative classifications are not conclusive. This study investigates the role of white matter disconnections in a patient whose symptoms are inconsistent with the mapping of the lesion site. A repeated neuropsychological investigation was associated with a review of the literature on the topic to identify the frequency of various different symptoms relating to this syndrome. Furthermore, an analysis of the neuroimaging regarding structural connectivity allowed us to investigate the grey matter lesions and white matter disconnections. The results indicated that some of the patient’s symptoms were associated with structures that, although not directly damaged, were dysfunctional due to a disconnection in their networks. This suggests that the anarchic hand may be considered as a disconnection syndrome involving the integration of multiple antero-posterior, insular and interhemispheric networks. In order to comprehend this rare syndrome better, the clinical and neuroimaging data need to be integrated with the clinical reports available in the literature on the topic.

Keywords

anarchic hand syndrome; DTI; white matter disconnection; lesion mapping; sense of agency; posterior lesions.

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