Anosognosia, or lack of self-awareness, is often present following neurological injury and can result in poor functional outcomes. The specific phenomenon of intellectual awareness, the knowledge that a function is impaired in oneself, has not been widely studied in post-stroke aphasia. We aim to identify behavioral and neural correlates of intellectual awareness by comparing stroke survivors’ self-reports of anomia to objective naming performance and examining lesion sites. Fifty-three participants with chronic aphasia without severe comprehension deficits rated their naming ability and completed a battery of behavioral tests. We calculated the reliability and accuracy of participant self-ratings, then examined the relationship of poor intellectual awareness to speech, language, and cognitive measures. We used support vector regression lesion-symptom mapping (SVR-LSM) to determine lesion locations associated with impaired and preserved intellectual awareness. Reliability and accuracy of self-ratings varied across the participants. Poor intellectual awareness was associated with reduced performance on tasks that rely on semantics. Our SVR-LSM results demonstrated that anterior inferior frontal lesions were associated with poor awareness, while mid-superior temporal lesions were associated with preserved awareness. An anterior-posterior gradient was evident in the unthresholded lesion-symptom maps. While many people with chronic aphasia and relatively intact comprehension can accurately and reliably report the severity of their anomia, others overestimate, underestimate, or inconsistently estimate their naming abilities. Clinicians should consider this when administering self-rating scales, particularly when semantic deficits or anterior inferior frontal lesions are present. Administering self-ratings on multiple days may be useful to check the reliability of patient perceptions.

神经损伤后通常会出现失认症或缺乏自我意识，并可能导致功能结果不佳。智力意识的具体现象，即自身功能受损的知识，在中风后失语症中尚未得到广泛研究。我们的目标是通过将中风幸存者的失智症自我报告与客观命名表现进行比较并检查病变部位，来确定智力意识的行为和神经相关性。53 名患有慢性失语症但没有严重理解缺陷的参与者评估了他们的命名能力并完成了一系列行为测试。我们计算了参与者自我评分的可靠性和准确性，然后研究了智力意识差与言语、语言和认知测量的关系。我们使用支持向量回归病变症状映射（SVR-LSM）来确定与受损和保留的智力意识相关的病变位置。参与者自我评级的可靠性和准确性各不相同。智力意识差与依赖语义的任务表现下降有关。我们的 SVR-LSM 结果表明，前下额叶病变与意识较差相关，而中上颞叶病变与意识保留相关。在未阈值病变症状图中，前后梯度很明显。虽然许多患有慢性失语症和相对完整的理解能力的人可以准确可靠地报告他们的失语症的严重程度，但其他人高估、低估或不一致地估计他们的命名能力。临床医生在使用自评量表时应考虑这一点，特别是当存在语义缺陷或前下额叶病变时。多天进行自我评级可能有助于检查患者认知的可靠性。