Síndrome de la mano extraña

Síndrome de la mano extraña
Clasificación y recursos externos
CIE-9	781.8
MeSH	D055964
Aviso médico

El síndrome de la mano extraña o síndrome de la mano ajena (o síndrome del Dr. Strangelove^[1] ) es un desorden mental raro en el cual una de las manos de quien lo padece parece adquirir vida propia.

El síndrome es más común en casos de personas las cuales han tenido una cirugía de separación de hemisferios cerebrales (comisurotomía), un procedimiento usado en ocasiones para relajar los síntomas de casos extremos de epilepsia. También ocurre en algunos otros casos de cirugía cerebral, golpes cerebrales o infecciones.

Síntomas

El padeciente del síndrome de la mano extraña puede sentir tacto en la mano, pero creer que no es parte de su cuerpo y que no poseen control sobre sus movimientos. Las manos extrañas pueden realizar actos complicados como abotonar y desabotonar una camisa. A menudo el paciente no es consciente de lo que su mano realiza hasta que llama su atención.

Los pacientes del síndrome de la mano extraña a menudo personifican el miembro independiente, por ejemplo creyendo que se encuentra "poseído" por algún espíritu y puede pelear o castigarlo en su intento por controlarlo.

Causas

Existen diversos subtipos del síndrome de la mano extraña asociados con tipos específicos de daño cerebral. El daño al cuerpo calloso puede producir acciones involuntarias e inteligentes en la mano no dominante del paciente (por ejemplo, en el caso de una persona diestra, su mano izquierda aparentará cobrar vida propia), mientras que un daño en el lóbulo frontal puede provocar acciones involuntarias e inteligentes en la mano dominante.

Daños en la corteza cerebral pueden provocar movimientos involuntarios, aunque descontrolados, de cualquiera de las manos del paciente y movimientos más complejos de la mano extraña son generalmente asociados a tumores cerebrales, aneurisma o golpes.

Se cree que el síndrome de la mano extraña resulta de la desconexión entre las distintas partes del cerebro con control sobre el cuerpo. Como resultado, diferentes regiones del cerebro son capaces de controlar los movimientos corporales sin ser conscientes de lo que están haciendo las otras partes del cerebro.

Tratamiento

No existe actualmente un tratamiento conocido para el síndrome de la mano extraña, aunque los síntomas pueden ser reducidos ocupando la mano extraña con alguna tarea, por ejemplo sosteniendo con ella algún objeto.

Curiosidades

• En la película Dr. Strangelove, Peter Sellers en una escena su mano parece cobrar vida propia^[2]

• En la película Al Diablo con el Diablo, Brendan Fraser en una escena pierde el control de su mano, aparentemente controlada por el Diablo. La escena está basada en esta enfermedad^{[3] [4]}

• En el capítulo 24 de la Quinta Temporada de House M. D. el paciente sufre de este síndrome.

• En la película El diablo metió la mano (Idle Hands en el inglés original del film de USA) se trata de un joven cuya mano fue poseída cobrando vida propia y matando a todo aquel que cruce a su paso.

Referencias

• Adamovich, S.V., August, K., Merians, A., & Tunik, E. (2009). A virtual reality-based system integrated with fMRI to study neural mechanisms of action observation-execution: a proof of concept study. Restorative Neurology and Neuroscience, 27, 209-223.
• Akelaitis, A. (1944–1945). Studies on the corpus callosum. IV. Diagonistic dyspraxia in epileptics following partial and complete section of the corpus callosum. American Journal of Psychiatry, 101, 594–599.
• Archibald, S.J., Mateer, C.A., & Kerns, K.A. (2001). Utilization behavior: clinical manifestations and neurological mechanisms. Neuropsychological Review, 11, 117-130.
• Assal, F., Schwartz, S., & Vuilleumier, P. (2007) Moving with or without will: Functional neural correlates of alien hand syndrome. Annals of Neurology, 62, 301-306.
• Banks, G., Short, P., Martinez, J., Latchaw, R., Ratcliff, G., & Boller, F. (1989). The alien hand syndrome: Clinical and postmortem findings. Archives of Neurology, 46, 456–459.
• Baynes, K., Tramo, M. J., Reeves, A. G., & Gazzaniga, M. S. (1997). Isolation of a right hemisphere cognitive system in a patient with anarchic (alien) hand sign. Neuropsychologia, 35, 1159–1173.
• Biran, I., Giovanetti, T., Buxbaum, L., Chatterjee, A. (2006). The alien hand syndrome. What makes the alien hand alien? Cognitive Neuropsychology 23, 563-582.
• Biran, I., & Chatterjee, A. (2004). Alien hand syndrome. Archives of Neurology, 61, 292–294.
• Blakemore, S. J., Wolpert, D. M., & Frith, C. D. (2002). Abnormalities in the awareness of action. Trends in Cognitive Sciences, 6, 237–242.
• Bogen, J. E. (1993). The Callosal syndrome. In K. M. Heilman & E. V. Valenstein (Eds.), Clinical neuropsychology (3rd ed., pp. 337–407). New York: Oxford University Press.
• Brion, S., & Jedynak, C. P. (1972). Disorders of interhemispheric transfer (callosal disconnection). 3 cases of tumor of the corpus callosum. [The ‘strange hand sign’]. Revue Neurologique (Paris), 126, 257–266.
• Bundick, T., & Spinella, M. (2000). Subjective experience, involuntary movement, and posterior alien hand syndrome. Journal of Neurology, Neurosurgery, and Psychiatry, 68, 83–85.
• Buxbaum, L. J., Schwartz, M. F., Coslett, H. B., & Carew, T. G. (1995). Naturalistic action and praxis in callosal apraxia. Neurocase, 1(3–17).
• Chan, J. L., & Liu, A. B. (1999). Anatomical correlates of alien hand syndromes. Neuropsychiatry, Neuropsychology, and Behavioral Neurology, 12, 149–155.
• Chatterjee, A. (1998). Feeling frontal dysfunction: Facilitory paratonia and the regulation of motor behavior. Neurology, 51, 937–939.
• Cooney, J. W., & Gazzaniga, M. S. (2003). Neurological disorders and the structure of human consciousness. Trends in Cognitive Sciences, 7, 161–165.
• David, N., Newen, A., Vogeley, K. (2008). The "sense of agency" and its underlying cognitive and neural mechanisms. Consciousness and Cognition, 17, 523-534.
• Della Sala, S., Marchetti, C., & Spinnler, H. (1991). Right-sided anarchic (alien) hand: A longitudinal study. Neuropsychologia, 29, 1113–1127.
• Denny-Brown, D. (1956). Positive and negative aspects of cerebral cortical functions. North Carolina Medical Journal, 17, 295-303.
• Denny-Brown, D. (1958). The nature of apraxia. The Journal of Nervous and Mental Disease, 126, 9–32.
• Denny-Brown, D. (1966). The cerebral control of movement. Liverpool: Liverpool University Press.
• Desmurget, M., & Grafton, S. (2000). Forward modeling allows feedback control for fast reaching movements. Trends in Cognitive Sciences, 4, 423–431.
• Doody, R.S., Jankovic, J. (1992). The alien hand and related signs. Journal of Neurology Neurosurgery and Psychiatry, 55, 806-810.
• Eslinger, P. J. (2002). The anatomic basis of utilization behavior: A shift from frontal-parietal to intrafrontal mechanisms. Cortex, 38, 273–276.
• Feinberg, T. E. (1997). Some interesting perturbations of the self in neurology. Seminars in Neurology, 17, 129–135.
• Feinberg, T. E., Schindler, R. J., Flanagan, N. G., & Haber, L. D. (1992). Two alien hand syndromes. Neurology, 42, 19–24.
• Fellows, L., & Farah, M. J. (2005). Is the anterior cingulate necessary for cognitive control? Brain, 128, 788–796.
• Fisher, C. M. (2000). Alien hand phenomena: A review with the addition of six personal cases. The Canadian Journal of Neurological Sciences, 27, 192–203.
• Frith C. D., Blakemore, S. J., & Wolpert, D. M. (2000). Abnormalities in the awareness and control of action. Philosophical Transactions of the Royal Society of London. Series B. Biological Sciences, 355(1404), 1771–1788.
• Gasquoine, P. G. (1993). Alien hand sign. Journal of Clinical and Experimental Neuropsychology, 15, 653–667.
• Gehring, W. J., & Knight, R. T. (2000). Prefrontal-cingulate interactions in action monitoring. Nature Neuroscience, 3, 516–520.
• Gerloff, C., Corwell, B., Chen, R., Hallet, M., & Cohen, L. G. (1997). Stimulation over the human supplementary motor area interferes with the organization of future elements in complex motor sequences. Brain, 120, 1587–1602.
• Ghahramani, Z. (2000). Computational neuroscience: Building blocks of movement. Nature, 407(6805), 682–683.
• Giovannetti, T., Buxbaum, L. J., Biran, I., & Chatterjee, A. (2005). Reduced endogenous control in alien hand syndrome: Evidence from naturalistic action. Neuropsychologia, 43, 75–88.
• Giovannetti, T., Libon, D. J., & Hart, T. (2002). Awareness of naturalistic action errors in dementia. Journal of the International Neuropsychological Society, 8, 633–644.
• Goldberg, G. (1985). Supplementary motor area structure and function: Review and hypothesis. Behavioral and Brain Sciences, 8, 567–616.
• Goldberg, G. (2000). Invited Editorial: When aliens invade: multiple mechanisms for dissociation between will and action. Journal of Neurology, Neurosurgery and Psychiatry 68, 7.
• Goldberg, G. (1987). From intent to action: Evolution and function of the premotor systems of the frontal lobe. In: The Frontal Lobes Re-visited. Ed. E. Perecman. IRBN Press.
• Goldberg, G. (1992). Premotor systems, attention to action and behavioural choice. In J. Kien, C. McCrohan, & W. Winlow (Eds.), Neurobiology of motor programme selection. New approaches to mechanisms of behavioural choice (pp. 225–249). Oxford: Pergamon Press.
• Goldberg, G., & Bloom, K. K. (1990). The alien hand sign: Localization, lateralization and recovery. American Journal of Physical Medicine and Rehabilitation, 69, 228–238.
• Goldberg, G., Mayer, N. H., & Toglia, J. U. (1981). Medial frontal cortex infarction and the alien hand sign. Archives of Neurology, 38, 683–686.
• Hart, T., Giovannetti, T., Montgomery, M. W., & Schwartz, M. F. (1998). Awareness of errors in naturalistic action after traumatic brain injury. The Journal of Head Trauma Rehabilitation, 13, 16–28.
• Jackson, J. H. (1958). On some implications of dissolution of the nervous system. In J. Taylor (Ed.), Selected writings of John Hughlings Jackson (vol 2, 1st ed., pp. 29–44). London: Staples Press.
• Jeannerod, M. (2007). Being oneself. Journal of Physiology (Paris), 101, 161-168.
• Jeannerod, M. (2009). The sense of agency and its disturbances in schizophrenia: a reappraisal. Experimental Brain Research, 192, 527-532.
• Kertesz, A. (2000). Alien hand, free will and Arnold Pick. The Canadian Journal of Neurological Sciences, 27, 183.
• Kessler, J., & Hathout, G. (2009). Dominant posterior-variant alien hand syndrome after acute left parietal infarction. Clinical Neurology and Neurosurgery, 111, 633-635. PMID: 19524356
• Kikkert, M.A., Ribbers, G.M., Koudstaal, P.J. (2006). Alien hand syndrome in stroke: a report of two cases and review of the literature. Archives of Physical Medicine and Rehabilitation, 87, 728-732.
• Kischka, U., Ettlin, T. M., Lichtenstern, L., & Riedo, C. (1996). Alien hand syndrome of the dominant hand and ideomotor apraxia of the nondominant hand. European Neurology, 36, 39–42.
• Kumral, E. (2001). Compulsive grasping hand syndrome: A variant of anarchic hand. Neurology, 57, 2143–2144.
• Levine, D. N., & Rinn, W. E. (1986). Opticosensory ataxia and alien hand syndrome after posterior cerebral artery territory infarction. Neurology, 36, 1094–1097.
• Lhermitte, F. (1983). “Utilization behaviour” and its relation to lesions of the frontal lobes. Brain, 106 (Pt 2), 237-255.
• Lhermitte, F., Pillon, B., Serdaru, M. (1986). Human autonomy and the frontal lobes. Part I: Imitation and utilization behavior. A neuropsychological study of 75 patients. Annals of Neurology, 19, 326-334.
• Lhermitte, F. (1986). Human autonomy and the frontal lobes. Part II: Patient behavior in complex and social situations: The "Environmental Dependency" syndrome. Annals of Neurology, 19, 335-343.
• Luria, A. R. (1966). Higher cortical functioning in man. New York: Oxford University Press.
• MacDonald, A. W., III, Cohen, J. D., Stenger, V. A., & Carter, C. S. (2000). Dissociating the role of the dorsolateral prefrontal and anterior cingulate cortex in cognitive control. Science, 288(5472), 1835–1838.
• Marchetti, C., & Della Sala, S. (1998). Disentangling the alien and anarchic hand. Cognitive Neuropsychiatry, 3, 191–208.
• Marey-Lopez, J.,Rubio-Nazabal,E., Alonso-Magdalena, L., & Lopez-Facal,S. (2002).Posterior alien hand syndrome after a right thalamic infarct. Journal of Neurology, Neurosurgery, and Psychiatry, 73, 447–449.
• McNabb, A. W., Carroll, W. M., & Mastaglia, F. L. (1988). “Alien hand” and loss of bimanual coordination after dominant anterior cerebral artery territory infarction. Journal of Neurology, Neurosurgery, and Psychiatry, 51, 218–222.
• Milner, A., & Goodale, M. (1995). The visual brain in action. New York: Oxford University Press.
• Moore, J.W., Wegner, D.M., Haggard, P. (2009). Modulating the sense of agency with external cues. Consciousness and Cognition, 18, 1056-1064.
• Nicholas, J.J., Wichner, M.H., Gorelick, P.B., Ramsey, M.M. (1998) "Naturalization" of the alien hand. A case report. Archives of Physical Medicine and Rehabilitation, 79, 113-114.
• Nishikawa, T., Okuda, J., Mizuta, I., Ohno, K., Jamshidi, J., Tokunaga, H., et al. (2001). Conflict of intentions due to callosal disconnection. Journal of Neurology, Neurosurgery, and Psychiatry, 71, 462–471.
• Norman, D. A., & Shallice, T. (1986). Attention to action; willed and automatic control of behavior. Consciousness and Self-Regulation, 4, 1–18.
• Ong Hai, B. G., & Odderson, I. R. (2000). Involuntary masturbation as a manifestation of stroke-related alien hand syndrome. American Journal of Physical Medicine and Rehabilitation, 79, 395–398.
• Pack, B.C., Stewart, K.J., Diamond, P.T., Gale, S.D. (2002). Posterior-variant alien hand syndrome: clinical features and response to rehabilitation. Disability and Rehabilitation, 24, 817-818.
• Parkin, A.J., & Barry, C. (1991). Alien hand sign and other cognitive deficits following ruptured aneurysm of the anterior communicating artery. Behavioral Neurology, 4, 167-179.
• Passingham, R. E., Ramnani, N., & Rowe, J. B. (2004). The motor system. In R. S. J. Frackowiak, K. J., Friston, C. D. Frith, R. J. Dolan, C. J. Price, S. Zeki, et al. (Eds.), Human brain function (pp. 5–32). New York: Elsevier Academic Press.
• Riddoch, M. J., Edwards, M. G., Humphreys, G. W., West, R., & Heafield, T. (1998). An experimental study of anarchic hand syndrome: Evidence that visual affordances direct action. Cognitive Neuropsychology, 15, 645–683.
• Rohde, S., Weidauer, S., Lanfermann, H., Zanelia, F. (2002). Posterior alien hand syndrome: case report. Neuroradiology, 44, 921-923.
• Sato, A. (2009). Both motor prediction and conceptual congruency between preview and action-effect contribute to explicit judgment of agency. Cognition, 110, 74-83.
• Scepkowski, L., & Cronin-Golomb, A. (2003). The alien hand: Cases, categorizations, and anatomic correlates. Behavioral and Cognitive Neuroscience Reviews, 2, 261–277.
• Spector, A.R., Freeman, W.D., & Cheshire, W.P. (2009). The stroke that struck back: an unusual alien hand presentation. Journal of Stroke and Cerebrovascular Diseases, 18, 72-73. PMID: 19110149
• Spengler, S., von Cramon, D.Y., & Brass, M. (2009). Was it me or was it you? How the sense of agency originates from ideomotor learning revealed by fMRI. Neuroimage, 46, 290-298.
• Sumner, P., & Husain, M. (2008). At the edge of consciousness: automatic motor activation and voluntary control. Neuroscientist, 14, 474-486.
• Suwanwela, N. C., & Leelacheavasit, N. (2002). Isolated corpus callosal infarction secondary to pericallosal artery disease presenting as alien hand syndrome. Journal of Neurology, Neurosurgery, and Psychiatry, 72, 533–536.
• Synofzik, M., Vosgerau, G., Newen, A. (2008). I move, therefore I am: a new theoretical framework to investigate agency and ownership. Consciousness and Cognition, 17, 411-424.
• Synofzik, M., Vosgerau, G., & Lindner, A. (2009). Me or not me—an optimal integration of agency cues? Consciousness and Cognition, 18, 1065-1068.
• Tanaka, Y., Iwasa, H., & Yoshida, M. (1990). Diagonistic dyspraxia: Case report and movement-related potentials. Neurology, 40, 657–661.
• Tanaka, Y., Yoshida, A., Kawahata, N., Hashimoto, R., & Obayashi, T. (1996). Diagonistic dyspraxia. Clinical characteristics, responsible lesion and possible underlying mechanism. Brain, 119 (Pt 3), 859–873.
• Trojano, L., Crisci, C., Lanzillo, B., Elefante, R., & Caruso, G. (1993). How many alien hand syndromes? Follow-up of a case. Neurology, 43, 2710–2712.
• Tsakiris, M., Schutz-Bosbach, S., Gallagher, S. (2007). On agency and body-ownership: phenomenological and neurocognitive reflections. Consciousness and Cognition, 16, 645-660.
• Turken, A. U., & Swick, D. (1999). Response selection in the human anterior cingulate cortex. Nature neuroscience, 2, 920–924
• Ventura, M. G., Goldman, S., & Hildebrand, J. (1995). Alien hand syndrome without a corpus callosum lesion. Journal of Neurology, Neurosurgery, and Psychiatry, 58, 735–737
• de Vignemont, F., & Fourneret, P. (2004). The sense of agency: a philosophical and empirical review of the "Who" system. Consciousness and Cognition, 13, 1-19
• Wolpert, D. M., Ghahramani, Z., & Flanagan, J. R. (2001). Perspectives and problems in motor learning. Trends in Cognitive Sciences, 5, 487–494

Enlaces externos

• Lesión callosa y dispraxia diagnóstica
• Un caso de síndrome de la mano ajena del tipo fronto-calloso (en formato PDF)
• Patologías extrañas