Reduced Sense of Agency After Right Insular Infarction With Severe Somatosensory Impairment: A Case Report

ABSTRACT

A 59‐year‐old man developed a right middle cerebral artery infarction involving the insula, resulting in severe contralateral somatosensory impairment and mild motor paresis. Despite preserved sense of limb ownership, he exhibited a reduced sense of agency, reflected in subjective difficulty generating and controlling movement. Rehabilitation consisting of sensory re‐education and visual feedback–based exercise therapy was administered. During rehabilitation, somatosensory function improved, accompanied by partial recovery of the sense of agency. This case suggests that post‐stroke motor dysfunction associated with somatosensory impairment may not be explained solely by sensory deficits but may also reflect a reduced sense of agency related to insular dysfunction. Considering the sense of agency in addition to somatosensory impairment may contribute to a better understanding of post‐stroke motor dysfunction and to more tailored rehabilitation strategies.