Network Neuroanatomy of Self-Awareness: A Narrative Review of Self-Referential Processing, Metacognition, and...

Self-awareness encompasses the capacity to recognize and evaluate information about oneself, including mental states, actions, autobiographical history, and bodily experience. Although closely related to consciousness, autobiographical memory, metacognition, clinical insight, anosognosia, and bodily self-consciousness, these constructs are not interchangeable. This focused narrative review synthesizes human neuroanatomical and neuroimaging evidence identified through a targeted PubMed/MEDLINE search covering January 1997 to August 15, 2026, supplemented by reference-chain searching. To improve methodological transparency, the revised review specifies eligibility principles, the narrative synthesis strategy, and reproducible domain-specific Boolean search strings; because the article is a narrative rather than a systematic review, no protocol registration, PRISMA screening flow, formal study-level risk-of-bias assessment, or quantitative pooling was undertaken. The evidence is organized into four interacting domains: self-referential representation, autobiographical continuity, metacognitive monitoring, and embodied self-processing. Cortical midline and default mode regions are prominent in self-referential evaluation; medial temporal systems support autobiographical information; anterior and lateral prefrontal and frontoparietal regions contribute to monitoring and updating; and temporoparietal, precuneal, insular, and sensorimotor regions contribute to bodily self-processing. Importantly, these macroscopic territories overlap and contain functionally heterogeneous subregions, so the proposed mappings represent network-weighted tendencies rather than one-to-one anatomical assignments. Clinical findings further show that anosognosia in Alzheimer's disease, impaired insight in schizophrenia, altered self-experience in depersonalization-derealization disorder, and awareness deficits after acquired brain injury (ABI) involve different combinations of these processes. We therefore propose a representation-memory-monitoring-embodiment framework as a heuristic neuroanatomical synthesis, not a diagnostic or treatment model. Its value lies in separating constructs often grouped under the term self-awareness and in generating testable hypotheses for longitudinal multimodal imaging, lesion mapping, causal studies, and construct-matched interventions.