## Abstract 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 cognitiv
Cognitive and functional neuroimaging correlate for anosognosia in Mild Cognitive Impairment and Alzheimer's disease
โ Scribed by Asmus Vogel; Steen G. Hasselbalch; Anders Gade; Morten Ziebell; Gunhild Waldemar
- Publisher
- John Wiley and Sons
- Year
- 2005
- Tongue
- English
- Weight
- 96 KB
- Volume
- 20
- Category
- Article
- ISSN
- 0885-6230
- DOI
- 10.1002/gps.1272
No coin nor oath required. For personal study only.
โฆ Synopsis
Abstract
Objectives
To investigate the correlation between anosognosia and behavioural symptoms, performance on executive tests, and frontal cortex regional cerebral blood flow (rCBF) in patients with โamnestic mild cognitive impairmentโ (MCI) and mild Alzheimer's disease (AD).
Methods
From a prospective Memory Clinic cohort including consecutively referred patients, age 60 years or above, and with MMSE score 20 or above, 36 patients with AD and 30 with MCI were included in this study. Anosognosia was assessed using a categorical scale and discrepancy scores between patients' and relatives' reports on a 20โitem Memory Questionnaire (MQ). Behavioural symptoms were assessed with Frontal Behavioural Inventory (FBI). Executive functions were examined with a range of neuropsychological tests. Tc99mโHMPAO SPECT was obtained in an unselected sample of 55 of the 66 patients, and rCBF was analysed in six cortical frontal regions.
Results
Insight was equally impaired in the two patient groups. A significant correlation was found between impaired awareness and dementia severity (MMSE). Discrepancyโscores on the MQ were significantly correlated to scores on FBI and to rCBF in the right inferior frontal gyrus, but not to executive tests. The groups classified by the categorical ratings โfullโ, โshallowโ and โnoโ awareness were not characterized by differences in behavioural symptoms, executive performance or frontal rCBF.
Conclusions
Impaired awareness is associated with behavioural symptoms and may reflect functional impairment in the right inferior frontal cortex. Copyright ยฉ 2005 John Wiley & Sons, Ltd.
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