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Impaired self-awareness of cognitive deficits in Parkinson's disease relates to cingulate cortex dysfunction
- Source :
- Psychological medicine 53(4), 1244-1253 (2023). doi:10.1017/S0033291721002725, Psychological medicine 1, 1-10 (2021). doi:10.1017/S0033291721002725
- Publication Year :
- 2021
- Publisher :
- Cambridge University Press (CUP), 2021.
-
Abstract
- BackgroundImpaired self-awareness of cognitive deficits (ISAcog) has rarely been investigated in Parkinson's disease (PD). ISAcog is associated with poorer long-term outcome in other diseases. This study examines ISAcog in PD with and without mild cognitive impairment (PD-MCI), compared to healthy controls, and its clinical-behavioral and neuroimaging correlates.MethodsWe examined 63 PD patients and 30 age- and education-matched healthy controls. Cognitive state was examined following the Movement Disorder Society Level II criteria. ISAcog was determined by subtracting z-scores (based on controls' scores) of objective tests and subjective questionnaires. Neural correlates were assessed by structural magnetic resonance imaging (MRI) and 2-[fluorine-18]fluoro-2-deoxy-d-glucose-positron emission tomography (FDG-PET) in 47 patients (43 with MRI) and 11 controls. We analyzed whole-brain glucose metabolism and cortical thickness in regions where FDG-uptake correlated with ISAcog.ResultsPD-MCI patients (N = 23) showed significantly more ISAcog than controls and patients without MCI (N = 40). When all patients who underwent FDG-PET were examined, metabolism in the bilateral superior medial frontal gyrus, anterior and midcingulate cortex negatively correlated with ISAcog (FWE-corrected p < 0.001). In PD-MCI, ISAcog was related to decreased metabolism in the right superior temporal lobe and insula (N = 13; FWE-corrected p = 0.023) as well as the midcingulate cortex (FWE-corrected p = 0.002). Cortical thickness was not associated with ISAcog in these regions. No significant correlations were found between ISAcog and glucose metabolism in controls and patients without MCI.ConclusionsSimilar to Alzheimer's disease, the cingulate cortex seems to be relevant in ISAcog in PD. In PD-MCI patients, ISAcog might result from a disrupted network that regulates awareness of cognition and error processes.
- Subjects :
- Cingulate cortex
Parkinson's disease
pathology [Cognitive Dysfunction]
diagnostic imaging [Cognitive Dysfunction]
etiology [Cognitive Dysfunction]
methods [Magnetic Resonance Imaging]
mild cognitive impairment
Fluorodeoxyglucose F18
metabolism [Gyrus Cinguli]
diagnostic imaging [Parkinson Disease]
metabolism [Fluorodeoxyglucose F18]
Humans
Medicine
ddc:610
Anosognosia
Applied Psychology
business.industry
physiology [Cognition]
multimodal neuroimaging
Brain
Cognition
medicine.disease
impaired self-awareness
Psychiatry and Mental health
Glucose
Self-awareness
complications [Parkinson Disease]
Tomography, X-Ray Computed
business
Neuroscience
Subjects
Details
- ISSN :
- 14698978 and 00332917
- Volume :
- 53
- Database :
- OpenAIRE
- Journal :
- Psychological Medicine
- Accession number :
- edsair.doi.dedup.....fe2e645905980d93480ebb1a0b7127b6