[en] We explored the neural substrate of anosognosia for cognitive impairment in Alzheimer's disease (AD). Two hundred nine patients with mild to moderate dementia and their caregivers assessed patients' cognitive impairment by answering a structured questionnaire. Subjects rated 13 cognitive domains as not impaired or associated with mild, moderate, severe, or very severe difficulties, and a sum score was calculated. Two measures of anosognosia were derived. A patient's self assessment, unconfounded by objective measurements of cognitive deficits such as dementia severity and episodic memory impairment, provided an estimate of impaired self-evaluative judgment about cognition in AD. Impaired self-evaluation was related to a decrease in brain metabolism measured with 18F-2-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) in orbital prefrontal cortex and in medial temporal structures. In a cognitive model of anosognosia, medial temporal dysfunction might impair a comparison mechanism between current information on cognition and personal knowledge. Hypoactivity in orbitofrontal cortex may not allow AD patients to update the qualitative judgment associated with their impaired cognitive abilities. Caregivers perceived greater cognitive impairments than patients did. The discrepancy score between caregiver's and patient's evaluations, an other measure of anosognosia, was negatively related to metabolic activity located in the temporoparietal junction, consistent with an impairment of self-referential processes and perspective taking in AD.
Research Center/Unit :
GIGA CRC (Cyclotron Research Center) In vivo Imaging-Aging & Memory - ULiège
Disciplines :
Radiology, nuclear medicine & imaging Neurosciences & behavior
Author, co-author :
Salmon, Eric ; Université de Liège - ULiège > Département des sciences cliniques > Neuroimagerie des troubles de la mémoire et révalid. cogn.
Perani, D.
Herholz, K.
Marique, P.
Kalbe, E.
Holthoff, V.
Delbeuck, X.
Beuthien-Baumann, B.
Pelati, O.
Lespagnard, Solange ; Centre Hospitalier Universitaire de Liège - CHU > Ophtalmologie
Collette, Fabienne ; Université de Liège - ULiège > Département des sciences cognitives > Neuropsychologie
Garraux, Gaëtan ; Université de Liège - ULiège > Département des sciences cliniques > Neurologie
Language :
English
Title :
Neural correlates of anosognosia for cognitive impairment in Alzheimer's disease
Publication date :
July 2006
Journal title :
Human Brain Mapping
ISSN :
1065-9471
eISSN :
1097-0193
Publisher :
Wiley Liss, Inc., Hoboken, United States - New Jersey
scite shows how a scientific paper has been cited by providing the context of the citation, a classification describing whether it supports, mentions, or contrasts the cited claim, and a label indicating in which section the citation was made.
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