Which symptom best indicates right-hemisphere cognitive-communication involvement (as opposed to left-hemisphere language impairment)?

• A. Left-hemisphere symptom
• B. Prosopagnosia
• C. Motor apraxia
• D. Anosognosia

Answer: (D)

The key idea is that right-hemisphere cognitive-communication problems are often revealed by deficits in self-awareness—how well a person recognizes and understands their own communication difficulties. Anosognosia is exactly that: a lack of awareness about one’s own deficits. When a person can’t acknowledge or monitor problems with communication, attention, or other cognitive skills, it points to right-hemisphere involvement rather than a primary left-hemisphere language impairment, which would show up as trouble producing or understanding speech itself.

Prosopagnosia, while also linked to right-hemisphere damage, is a perceptual deficit in recognizing faces and doesn’t primarily reflect communication or self-awareness problems. Motor apraxia relates to planning or performing movements and isn’t specifically a language or communication deficit. So the symptom most diagnostic for distinguishing right-hemisphere cognitive-communication involvement from left-hemisphere language impairment is the lack of awareness of one’s own deficits: anosognosia.