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Lau G, Moulin CJA, Portrat S. Retrospective judgments of confidence in a complex span task. Sci Rep 2023; 13:18535. [PMID: 37898700 PMCID: PMC10613295 DOI: 10.1038/s41598-023-45552-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 10/20/2023] [Indexed: 10/30/2023] Open
Abstract
Although the study of metamemory monitoring originated in predictions for simple span tasks, the study of metacognition for working memory (WM) has been somewhat neglected in comparison with long-term memory. We aimed to fill this gap by exploring the ability to self-assess WM operations. Thirty-four participants performed 16 series of complex span tasks and rated their confidence in a verbal recall paradigm. We manipulated the cognitive load based on the TBRS model in order to analyze the role of attentional resources on both WM and metacognitive evaluations. As expected, we found that recall is affected by cognitive load and we found standard serial position effects. Interestingly, metacognitive evaluations followed the same pattern, and measures of metacognitive sensitivity suggest that participants are able to make item-by-item retrospective judgments reflective of their performance. We discuss how these results contribute to our understanding of metacognitive access to newly-formed WM contents.
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Affiliation(s)
- Giovanny Lau
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, CNRS, LPNC, 38000, Grenoble, France.
| | - Chris J A Moulin
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, CNRS, LPNC, 38000, Grenoble, France
| | - Sophie Portrat
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, CNRS, LPNC, 38000, Grenoble, France
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Li Q, Sun X, Cui L, Zhong Y, Wang B, Miao Y, Hu X, Guo Q. Alterations in metamemory capacity and neural correlates in a subtype of subjective cognitive decline. NEUROIMAGE: CLINICAL 2022; 36:103255. [PMID: 36451360 PMCID: PMC9668650 DOI: 10.1016/j.nicl.2022.103255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 10/19/2022] [Accepted: 10/31/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUNDS Subjective cognitive decline (SCD), one of the important clinical indicators for preclinical Alzheimer's disease (AD), is primarily defined as self-perceived cognitive decline without objective evidence for cognitive impairment. However, the accuracy of their self-evaluation of cognition is unclear. This study sought to investigate the capacity for self-evaluation of own cognitive performance in SCD by applying an objective metamemory paradigm. METHODS 147 individuals with SCD were classified into four subgroups by their subjective feeling of worse performance than peers or not (P+/-) and whether they have objectively slight cognitive impairment compared to normative data (S+/-). Metamemory scores, the amplitude of the low-frequency fluctuation (ALFF), fractional low-frequency fluctuation amplitude (fALFF), and cortical thickness were compared among four subgroups. Partial correlations between neuropsychological scores and neuroimaging measures were examined, controlling for age, sex, and education years. RESULTS SCD S+P- showed the worst performance in short-term delayed recall and the worst metamemory performance, indicated by the highest value in the degree of confidence of short-term delayed recall (DOC-N4) and long-term cued recall (DOC-N6) and the worst value in relative accuracy of judgments of short-term delayed recall (ROJ-N4). ALFF values in the bilateral superior medial frontal and olfactory cortices and the left superior orbitofrontal gyrus cortex were significantly higher in SCD P- compared with SCD P+ groups (all P < 0.05, FWE-corrected, cluster-wise level). A significant S × P interaction effect in the left hippocampus and middle cingulate cortex was found for the fALFF signals (all P < 0.05, FWE-corrected, cluster-wise level). Significant interaction and main effects on cortical thickness were reported. The parahippocampal and posterior cingulate cortices were significantly decreased in SCD S+P- (all P < 0.05). CONCLUSION SCD S+P- showed the worst episodic memory performance, altered metamemory capacity (overconfidence and less accuracy of judgment), and altered neuroimaging measures, though they had feelings of similar performance with peers. Our results indicate that metamemory capacity is affected in a subtype of SCD with reduced cortical thickness and intensity of regional spontaneous activity in key areas for metamemory processing.
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Affiliation(s)
- Qinjie Li
- Department of Gerontology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
| | - Xiaokang Sun
- Department of Gerontology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
| | - Liang Cui
- Department of Gerontology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
| | - Yuan Zhong
- Department of Gerontology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
| | - Beiyun Wang
- Department of Gerontology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
| | - Ya Miao
- Department of Gerontology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
| | - Xiaochen Hu
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany,Corresponding authors.
| | - Qihao Guo
- Department of Gerontology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China,Corresponding authors.
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Chi SY, Chua EF, Kieschnick DW, Rabin LA. Prospective Metamemory Monitoring of Episodic Visual Memory in Community-Dwelling Older Adults with Subjective Cognitive Decline and Mild Cognitive Impairment. Arch Clin Neuropsychol 2021; 36:1404–1425. [PMID: 33893475 DOI: 10.1093/arclin/acab008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2021] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE Metamemory tasks have been utilized to investigate anosognosia in older adults with dementia, though previous research has not systematically compared memory self-awareness in prodromal dementia groups. This represents an important oversight given that remedial and interventional efforts may be most beneficial before individuals' transition to clinical dementia. We examine differences in memory self-awareness and memory self-monitoring between cognitively healthy elderly controls and prodromal dementia groups. METHODS Participants with subjective cognitive decline despite intact objective neuropsychological functioning (SCD; n = 82), amnestic mild cognitive impairment (aMCI; n = 18), nonamnestic mild cognitive impairment (naMCI; n = 38), and normal cognitive functioning (HC; n = 120) were recruited from the Einstein Aging Study for a cross-sectional study. Participants completed an experimental visual memory-based global metamemory prediction task and subjective assessments of memory/cognition and self-awareness. RESULTS While, relative to HC, memory self-awareness and memory self-monitoring were preserved for delayed memory performance in SCD and aMCI, these processes were impaired in naMCI. Furthermore, results suggest that poor metamemory accuracy captured by our experimental task can be generalized to everyday memory problems. CONCLUSIONS Within the framework of the Cognitive Awareness Model, our findings provide preliminary evidence that poor memory self-awareness/self-monitoring in naMCI may reflect an executive or primary anosognosia, with implications for tailored rehabilitative interventions.
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Affiliation(s)
- Susan Y Chi
- Queens College, City University of New York, Queens, NY, USA
- Graduate Center, City University of New York, New York, NY, USA
- University of California at San Francisco, Weill Institute for Neurosciences, San Francisco, CA, USA
- Framework Associates, Santa Monica, CA, USA
| | - Elizabeth F Chua
- Graduate Center, City University of New York, New York, NY, USA
- Brooklyn College, City University of New York, Brooklyn, NY, USA
| | - Dustin W Kieschnick
- University of California at San Francisco, Weill Institute for Neurosciences, San Francisco, CA, USA
| | - Laura A Rabin
- Queens College, City University of New York, Queens, NY, USA
- Graduate Center, City University of New York, New York, NY, USA
- Brooklyn College, City University of New York, Brooklyn, NY, USA
- Albert Einstein College of Medicine, Einstein Aging Study, Bronx, NY, USA
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Cacciamani F, Houot M, Gagliardi G, Dubois B, Sikkes S, Sánchez-Benavides G, Denicolò E, Molinuevo JL, Vannini P, Epelbaum S. Awareness of Cognitive Decline in Patients With Alzheimer's Disease: A Systematic Review and Meta-Analysis. Front Aging Neurosci 2021; 13:697234. [PMID: 34413767 PMCID: PMC8370471 DOI: 10.3389/fnagi.2021.697234] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 06/22/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Identifying a poor degree of awareness of cognitive decline (ACD) could represent an early indicator of Alzheimer's disease (AD). Objectives: (1) to understand whether there is evidence of poor ACD in the pre-dementia stages of AD; (2) to summarize the main findings obtained investigating ACD in AD; (3) to propose a conceptual framework. Data Sources: We searched Scopus, Pubmed, and the reference lists for studies published up to August 2020. Original research articles must report a measure of ACD and included individuals with AD dementia, or prodromal AD (or MCI), or being at risk for AD. Data Synthesis: All studies covering preclinical, prodromal, and AD dementia were systematically reviewed. We intended to perform a meta-analysis of empirical studies on preclinical AD or prodromal AD (or MCI), to compare ACD between clinical groups. Due to the paucity of literature on preclinical AD, meta-analysis was only possible for prodromal AD (or MCI) studies. Results: We systematically reviewed 283 articles, and conducted a meta-analysis of 18 articles on prodromal AD (or MCI), showing that ACD was not significantly different between patients with amnestic and non-amnestic MCI (SMD = 0.09, p = 0.574); ACD was significantly poorer in amnestic MCI (SMD = -0.56, p = 0.001) and mild AD (SMD = -1.39, p < 0.001) than in controls; ACD was also significantly poorer in mild AD than in amnestic MCI (SMD = -0.75, p < 0.001), as well as poorer than in non-amnestic MCI (SMD = -1.00, p < 0.001). We also discuss key findings on ACD in AD, such as its neural and cognitive correlates. Conclusions and Implications: We propose that patients may be complaining of their initial subtle cognitive changes, but ACD would soon start to decrease. The individual would show mild anosognosia in the MCI stage, and severe anosognosia in dementia. The evaluation of ACD (comparing self-report to cognitive scores or to informant-report) could be useful to guide the clinician toward a timely diagnosis, and in trials targeting early-stage AD.
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Affiliation(s)
- Federica Cacciamani
- Institut du Cerveau, ICM, Hôpital de la Pitié-Salpêtrière, Paris, France
- Inserm, U 1127, Paris, France
- CNRS, UMR 7225, Paris, France
- Sorbonne Université, Paris, France
- Inria, ARAMIS-Project Team, Paris, France
| | - Marion Houot
- Institut du Cerveau, ICM, Hôpital de la Pitié-Salpêtrière, Paris, France
- Sorbonne Université, Paris, France
- Institute of Memory and Alzheimer's Disease (IM2A), Centre of Excellence of Neurodegenerative Disease (CoEN), ICM, CIC Neurosciences, AP-HP, Department of Neurology, Hôpital de la Pitié-Salpêtrière, Sorbonne University, Paris, France
| | - Geoffroy Gagliardi
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
- Department of Neurology, Center for Alzheimer Research and Treatment, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Bruno Dubois
- Institut du Cerveau, ICM, Hôpital de la Pitié-Salpêtrière, Paris, France
- Inserm, U 1127, Paris, France
- CNRS, UMR 7225, Paris, France
- Sorbonne Université, Paris, France
- Institute of Memory and Alzheimer's Disease (IM2A), Centre of Excellence of Neurodegenerative Disease (CoEN), ICM, CIC Neurosciences, AP-HP, Department of Neurology, Hôpital de la Pitié-Salpêtrière, Sorbonne University, Paris, France
| | - Sietske Sikkes
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Amsterdam University Medical Center (UMC), Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Gonzalo Sánchez-Benavides
- BarcelonaBeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - Elena Denicolò
- Department of Biomedical Science and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - José Luis Molinuevo
- BarcelonaBeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
| | - Patrizia Vannini
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
- Department of Neurology, Center for Alzheimer Research and Treatment, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Stéphane Epelbaum
- Institut du Cerveau, ICM, Hôpital de la Pitié-Salpêtrière, Paris, France
- Inserm, U 1127, Paris, France
- CNRS, UMR 7225, Paris, France
- Sorbonne Université, Paris, France
- Inria, ARAMIS-Project Team, Paris, France
- Institute of Memory and Alzheimer's Disease (IM2A), Centre of Excellence of Neurodegenerative Disease (CoEN), ICM, CIC Neurosciences, AP-HP, Department of Neurology, Hôpital de la Pitié-Salpêtrière, Sorbonne University, Paris, France
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Martín-Luengo B, Zinchenko O, Dolgoarshinnaia A, Leminen A. Retrospective confidence judgments: Meta-analysis of functional magnetic resonance imaging studies. Hum Brain Mapp 2021; 42:3005-3022. [PMID: 33951247 PMCID: PMC8193539 DOI: 10.1002/hbm.25397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 02/18/2021] [Indexed: 12/25/2022] Open
Abstract
Confidence in our retrieved memories, that is, retrospective confidence, is a metamemory process we perform daily. There is an abundance of applied research focusing on the metamemory judgments and very diverse studies including a wide range of clinical populations. However, the neural correlates that support its functioning are not well defined impeding the implementation of noninvasive neuromodulatory clinical interventions. To address the neural basis of metamemory judgments, we ran a meta‐analysis, where we used the activation likelihood estimation method on the 19 eligible functional magnetic resonance imaging studies. The main analysis of retrospective confidence revealed concordant bilateral activation in the parahippocampal gyrus, left middle frontal gyrus, and right amygdala. We also run an analysis between the two extreme levels of confidence, namely, high and low. This additional analysis was exploratory, since the minimum amount of articles reporting these two levels was not reached. Activations for the exploratory high > low confidence subtraction analysis were the same as observed in the main analysis on retrospective confidence, whereas the exploratory low > high subtraction showed distinctive activations of the right precuneus. The involvement of the right precuneus emphasizes its role in the evaluation of low confidence memories, as suggested by previous studies. Overall, our study contributes to a better understanding of the specific brain structures involved in confidence evaluations. Better understanding of the neural basis of metamemory might eventually lead to designing more precise neuromodulatory interventions, significantly improving treatment of patients suffering from metamemory problems.
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Affiliation(s)
- Beatriz Martín-Luengo
- Centre for Cognition and Decision Making, Institute for Cognitive Neuroscience, National Research University Higher School of Economics, Moscow, Russian Federation
| | - Oksana Zinchenko
- Centre for Cognition and Decision Making, Institute for Cognitive Neuroscience, National Research University Higher School of Economics, Moscow, Russian Federation.,International Laboratory for Social Neurobiology, Institute for Cognitive Neuroscience, National Research University Higher School of Economics, Moscow, Russian Federation
| | - Aleksandra Dolgoarshinnaia
- Centre for Cognition and Decision Making, Institute for Cognitive Neuroscience, National Research University Higher School of Economics, Moscow, Russian Federation
| | - Alina Leminen
- Cognitive Science, Department of Digital Humanities, Faculty of Arts, University of Helsinki, Helsinki, Finland.,Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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Bertrand E, van Duinkerken E, Laks J, Dourado MCN, Bernardes G, Landeira-Fernandez J, Mograbi DC. Structural Gray and White Matter Correlates of Awareness in Alzheimer's Disease. J Alzheimers Dis 2021; 81:1321-1330. [PMID: 33935073 DOI: 10.3233/jad-201246] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Unawareness of disease is a common feature of Alzheimer's disease (AD), but few studies explored its neural correlates. Additionally, neural correlates according to the object of awareness are unexplored. OBJECTIVE To investigate structural brain correlates in relation to different objects of awareness. METHODS 27 people with AD underwent MRI scanning on a 3T Siemens Prisma. T1-MPRAGE was used to investigate cortical thickness and white matter microstructure was defined by DTI as fractional anisotropy, mean, axial, and radial diffusivity. Preprocessing used FreeSurfer6.0, ExploreDTI, and FSL-TBSS. Awareness of disease, cognitive deficits, emotional state, relationships, and functional capacity were assessed with the short version of the Assessment Scale of Psychosocial Impact of the Diagnosis of Dementia. Voxel-wise correlations between brain structure and awareness were determined by FSL-PALM. Analyses were corrected for multiple comparisons using Threshold Free Cluster Enhancement and FWE. RESULTS Lower left hemisphere cortical thickness was related to poorer disease awareness uncorrected and corrected for age, sex, and MMSE. In the uncorrected model, mainly right-sided, but also left temporal lower cortical thickness was related to decreased awareness of cognitive deficits. Correcting for age, sex, and MMSE eliminated correlations for the right hemisphere, but extensive correlations in the left hemisphere remained. For white matter integrity, higher right hemisphere MD was related to lower cognitive awareness deficits, and lower FA was related to lower functional capacity awareness. CONCLUSION Findings suggest that extensive regions of the brain are linked to self-awareness, with particular frontal and temporal alterations leading to unawareness, in agreement with theoretical models indicating executive and mnemonic forms of anosognosia in AD.
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Affiliation(s)
- Elodie Bertrand
- MC2Lab (URP 7536), Institut de Psychologie, Université de Paris, Paris, France.,Department of Psychology, Pontifícia Universidade Católica-Rio (PUC-Rio), Rio de Janeiro, Brazil
| | - Eelco van Duinkerken
- Department of Medical Psychology, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands.,Center for Epilepsy, Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro, Brazil.,Postgraduate Program in Neurology, Hospital Universitário Gaffrée e Guinle -UNIRIO, Rio de Janeiro, Brazil
| | - Jerson Laks
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.,Department of Psychology, Universidade do Grande Rio (Unigranrio), Duque de Caxias, Brazil
| | | | - Gabriel Bernardes
- Department of Psychology, Pontifícia Universidade Católica-Rio (PUC-Rio), Rio de Janeiro, Brazil
| | - Jesus Landeira-Fernandez
- Department of Psychology, Pontifícia Universidade Católica-Rio (PUC-Rio), Rio de Janeiro, Brazil
| | - Daniel C Mograbi
- Department of Psychology, Pontifícia Universidade Católica-Rio (PUC-Rio), Rio de Janeiro, Brazil.,Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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White matter network disruption and cognitive correlates underlying impaired memory awareness in mild cognitive impairment. NEUROIMAGE-CLINICAL 2021; 30:102626. [PMID: 33780863 PMCID: PMC8039854 DOI: 10.1016/j.nicl.2021.102626] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 02/03/2021] [Accepted: 03/05/2021] [Indexed: 11/20/2022]
Abstract
Episodic memory deficits are insufficient for explaining memory anosognosia in MCI. Reasoning ability can be used as a basis for identifying memory anosognosia in MCI. Memory anosognosia in MCI is a white matter disconnection syndrome. Frontal-subcortical and callosal fibers are linked to memory anosognosia in MCI.
Decreased awareness of memory declines in mild cognitive impairment (MCI) has been linked to structural or functional changes in a wide gray matter network; however, the underlying white matter pathway correlations for the memory awareness deficits remain unknown. Moreover, consistent findings have not been obtained regarding the cognitive basis of disturbed awareness of memory declines in MCI. Due to the methodological drawbacks (e.g., correlational analysis without controlling confounders related to clinical status, a problem related to the representativeness of the control group) of previous studies on the aforementioned topic, further investigation is required. To addressed the research gaps, this study investigated white matter microstructural integrity and the cognitive correlates of memory awareness in 87 older adults with or without mild cognitive impairment (MCI). The patients with MCI and healthy controls (HCs) were divided into two subgroups, namely those with normal awareness (NA) and poor awareness (PA) for memory deficit, according to the discrepancy scores calculated from the differences between subjective and objective memory evaluations. Only the results for HCs with NA (HC-NA) were compared with those for the two MCI groups (i.e., MCI-NA and MCI-PA). The three groups were matched on demographic and clinical variables. An advanced diffusion imaging technique—diffusion spectrum imaging—was used to investigate the integrity of the white matter tract. The results revealed that although the HC-NA group outperformed the two MCI groups on several cognitive tests, the two MCI groups exhibited comparable performance across different neuropsychological tests, except for the test on reasoning ability. Compared with the other two groups, the MCI-PA group exhibited lower integrity in bilateral frontal-striatal fibers, left anterior thalamocortical radiations, and callosal fibers connecting bilateral inferior parietal regions. These results could not be explained by gray matter morphometric differences. Overall, the results indicated that mnemonic anosognosia was not sufficient to explain the memory awareness deficits observed in the patients with MCI. Our brain imaging findings also support the concept of anosognosia for memory deficit as a disconnection syndrome in MCI.
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Lenzoni S, Morris RG, Mograbi DC. The Petrified Self 10 Years After: Current Evidence for Mnemonic anosognosia. Front Psychol 2020; 11:465. [PMID: 32256435 PMCID: PMC7090331 DOI: 10.3389/fpsyg.2020.00465] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 02/27/2020] [Indexed: 12/14/2022] Open
Abstract
Lack of awareness about disease, its symptoms and consequences, also termed anosognosia, is a common feature of Alzheimer's disease (AD). It has been hypothesized that memory disorder may be a key contributing factor to anosognosia, with people with AD not being able to update their personal information about performance and relying on older consolidated material about ability. This potentially outdated sense of self has been named, as a metaphor, the petrified self. In the current review, evidence from the past 10 years in relation to this concept is critically appraised. In particular, focus is given to empirical evidence produced on anterograde memory deficits about performance, the profile of autobiographical retrograde memory loss and the role of frontal lobes in anosognosia in AD. Finally, wider consequences of this metaphor for the understanding of selfhood in dementia are discussed.
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Affiliation(s)
- Sabrina Lenzoni
- Department of Psychology, Pontifícia Universidade Católica, Rio de Janeiro, Brazil
| | - Robin G Morris
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Daniel C Mograbi
- Department of Psychology, Pontifícia Universidade Católica, Rio de Janeiro, Brazil.,Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
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