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Si Y, He R, Jiang L, Yao D, Zhang H, Xu P, Ma X, Yu L, Li F. Differentiating Between Alzheimer's Disease and Frontotemporal Dementia Based on the Resting-State Multilayer EEG Network. IEEE Trans Neural Syst Rehabil Eng 2023; 31:4521-4527. [PMID: 37922187 DOI: 10.1109/tnsre.2023.3329174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2023]
Abstract
Frontotemporal dementia (FTD) is frequently misdiagnosed as Alzheimer's disease (AD) due to similar clinical symptoms. In this study, we constructed frequency-based multilayer resting-state electroencephalogram (EEG) networks and extracted representative network features to improve the differentiation between AD and FTD. When compared with healthy controls (HC), AD showed primarily stronger delta-alpha cross-couplings and weaker theta-sigma cross-couplings. Notably, when comparing the AD and FTD groups, we found that the AD exhibited stronger delta-alpha and delta-beta connectivity than the FTD. Thereafter, by extracting the representative network features and then applying these features in the classification between AD and FTD, an accuracy of 81.1% was achieved. Finally, a multivariable linear regressive model was built, based on the differential topologies, and then adopted to predict the scores of the Mini-Mental State Examination (MMSE) scale. Accordingly, the predicted and actual measured scores were indeed significantly correlated with each other ( r = 0.274, p = 0.036). These findings consistently suggest that frequency-based multilayer resting-state networks can be utilized for classifying AD and FTD and have potential applications for clinical diagnosis.
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Chapman S, Joyce JL, Barker MS, Sunderaraman P, Rizer S, Huey ED, Dworkin J, Gu Y, Cosentino S. Subjective Cognitive Decline Is More Accurate When Metamemory Is Better. Front Aging Neurosci 2022; 14:787552. [PMID: 35370602 PMCID: PMC8965471 DOI: 10.3389/fnagi.2022.787552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 01/24/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Subjective cognitive decline (SCD) has emerged as one of the first manifestations of Alzheimer's disease (AD). However, discrepancies in its relationship with tests of memory and other cognitive abilities have hindered SCD's diagnostic utility. Inter-individual heterogeneity in metamemory, or memory awareness, and the use of clinical measures of cognition lacking sensitivity to early cognitive dysfunction, may contribute to these discrepancies. We aimed to assess if the relationship between SCD and markers of early cognitive dysfunction is moderated by metamemory abilities. Methods The sample included 79 cognitively healthy older adults (77% female, 68% White, and 32% Black participants) with a mean age of 74.4 (SD = 6.1) and 15.9 (SD = 2.7) years of education. Metamemory was assessed using an episodic Feeling of Knowing test with four 5-item trials. Outcome measures included a resolution metric defined as a gamma correlation reflecting the accuracy of item-level predictions ("Will you know the correct answer?"). Early cognitive dysfunction was measured through the Loewenstein-Acevedo Scale for Semantic Interference and Learning (LASSI-L) and the Short-Term Memory Binding Test (STMB), measures sensitive to preclinical AD. SCD was assessed with a 20-item questionnaire that asked participants to compare themselves to others their age on a 7-point Likert scale. Regression analyses examined whether a potential relation between SCD and early cognitive dysfunction was moderated by metamemory. Results Subjective cognitive decline was associated with susceptibility to semantic proactive interference such that greater complaints were associated with increased susceptibility to semantic proactive interference (b = -0.30, p = 0.003) only. Metamemory moderated the association between SCD and susceptibility to and recovery of semantic proactive interference such that those with more accurate metamemory showed a stronger association between increased complaints and susceptibility to semantic proactive interference (b = -0.71, p = 0.005; b = -0.62, p = 0.034). Metamemory, however, did not moderate the association of SCD with retroactive semantic interference nor short term memory binding. Discussion The accuracy of an individual's metamemory, specifically their ability to adjust moment to moment predictions in line with their performance, can influence the extent to which SCD maps onto objective cognition. Such self-referential assessment should be considered when interpreting SCD.
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Affiliation(s)
- Silvia Chapman
- Cognitive Neuroscience Division, Columbia University Irving Medical Center, New York, NY, United States
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Irving Medical Center, New York, NY, United States
| | - Jillian L. Joyce
- Cognitive Neuroscience Division, Columbia University Irving Medical Center, New York, NY, United States
- Gertrude H. Sergievsky Center, Columbia University Irving Medical Center, New York, NY, United States
| | - Megan S. Barker
- Cognitive Neuroscience Division, Columbia University Irving Medical Center, New York, NY, United States
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Irving Medical Center, New York, NY, United States
| | - Preeti Sunderaraman
- Cognitive Neuroscience Division, Columbia University Irving Medical Center, New York, NY, United States
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Irving Medical Center, New York, NY, United States
- Gertrude H. Sergievsky Center, Columbia University Irving Medical Center, New York, NY, United States
- Department of Neurology, Columbia University Irving Medical Center, New York, NY, United States
- Department of Neurology, Boston University School of Medicine, Boston, MA, United States
- Brain Aging Program, Framingham Heart Study, Framingham, MA, United States
| | - Sandra Rizer
- Cognitive Neuroscience Division, Columbia University Irving Medical Center, New York, NY, United States
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Irving Medical Center, New York, NY, United States
| | - Edward D. Huey
- Cognitive Neuroscience Division, Columbia University Irving Medical Center, New York, NY, United States
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Irving Medical Center, New York, NY, United States
- Gertrude H. Sergievsky Center, Columbia University Irving Medical Center, New York, NY, United States
- Department of Neurology, Columbia University Irving Medical Center, New York, NY, United States
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, United States
| | - Jordan Dworkin
- Cognitive Neuroscience Division, Columbia University Irving Medical Center, New York, NY, United States
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, United States
| | - Yian Gu
- Cognitive Neuroscience Division, Columbia University Irving Medical Center, New York, NY, United States
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Irving Medical Center, New York, NY, United States
- Department of Neurology, Columbia University Irving Medical Center, New York, NY, United States
| | - Stephanie Cosentino
- Cognitive Neuroscience Division, Columbia University Irving Medical Center, New York, NY, United States
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Irving Medical Center, New York, NY, United States
- Gertrude H. Sergievsky Center, Columbia University Irving Medical Center, New York, NY, United States
- Department of Neurology, Columbia University Irving Medical Center, New York, NY, United States
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Sharma V, Sagar R, Kaloiya G, Mehta M. The Scope of Metacognitive Therapy in the Treatment of Psychiatric Disorders. Cureus 2022; 14:e23424. [PMID: 35475111 PMCID: PMC9030663 DOI: 10.7759/cureus.23424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 03/23/2022] [Indexed: 12/17/2022] Open
Abstract
Metacognitive therapy (MCT) is a novel and promising transdiagnostic psychotherapy intervention based on the Self-Regulatory Executive Function model of conceptualizing emotional disorders. It was developed by Adrian Wells in 2009. Its therapeutic response occurs by reducing dysfunctional metacognitive beliefs regarding worry and rumination, often seen in patients with psychiatric disorders. Since its inception, it has been increasingly applied to a wide spectrum of psychiatric illnesses, but mainly focusing on mood and anxiety disorders. To our knowledge, no study has detailed its existing therapeutic scope in psychiatry. In this comprehensive narrative review, we describe the various psychiatric illnesses in which MCT has been used, the advantages of MCT, and the limitations of the MCT research. In addition, we propose some solutions to systematically examine its place in psychiatry. We encountered its potential role in treating trauma and stress-related disorders, obsessive-compulsive spectrum disorders, personality disorders, psychotic disorders, substance use disorders, and sexual disorders.
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Affiliation(s)
- Vandita Sharma
- Psychiatry, All India Institute of Medical Sciences, New Delhi, New Delhi, IND
| | - Rajesh Sagar
- Psychiatry, All India Institute of Medical Sciences, New Delhi, New Delhi, IND
| | | | - Manju Mehta
- Psychiatry, All India Institute of Medical Sciences, New Delhi, New Delhi, IND
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de Ruijter NS, Schoonbrood AMG, van Twillert B, Hoff EI. Anosognosia in dementia: A review of current assessment instruments. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2020; 12:e12079. [PMID: 33024810 PMCID: PMC7527687 DOI: 10.1002/dad2.12079] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 07/09/2020] [Accepted: 07/13/2020] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Anosognosia is a common but underrated symptom in dementia and has significant impact on both patients and caregivers. A proper evaluation of anosognosia is therefore desirable. There are three common methods to determine anosognosia: (1) clinical rating, (2) patient-caregiver discrepancies, and (3) prediction of performance discrepancies. Each of them includes different instruments. This review gives an overview of the current instruments used for the assessment of anosognosia in patients with dementia and aims to determine the most suitable instrument for routine use in clinical practice. METHODS A search of the literature in PubMed was performed. Furthermore, electronic databases (PsycINFo, ClinicalKey, and Cochrane Library) and reference lists were searched for additional articles. RESULTS Forty-six articles were included in this study, comprising 10 clinical rating instruments, 25 patient-caregiver discrepancy instruments, and 14 prediction-performance discrepancy instruments. For every publication, the aims of the study, the included population, the assessment instrument used, the assessed domains, and the psychometric properties of the assessment instruments are described. CONCLUSIONS Currently, there is no consensus on the most suitable method to determine anosognosia in dementia. We recommend the Clinical Insight Rating scale and the Abridged Anosognosia Questionnaire-Dementia as the most appropriate for routine use in clinical practice.
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Affiliation(s)
- Naomi S de Ruijter
- Department of Neurology Zuyderland Medical Centre Heerlen the Netherlands
| | | | - Björn van Twillert
- Department of Medical Psychology Zuyderland Medical Centre Heerlen the Netherlands
| | - Erik I Hoff
- Department of Neurology Zuyderland Medical Centre Heerlen the Netherlands
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Belli E, Nicoletti V, Radicchi C, Bonaccorsi J, Cintoli S, Ceravolo R, Tognoni G. Confabulations in Cases of Dementia: Atypical Early Sign of Alzheimer’s Disease or Misleading Feature in Dementia Diagnosis? Front Psychol 2020; 11:553886. [PMID: 33117224 PMCID: PMC7550794 DOI: 10.3389/fpsyg.2020.553886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 09/07/2020] [Indexed: 11/21/2022] Open
Abstract
Confabulations, also known as false memories, have been associated with various diseases involving mainly the frontal areas, such as Wernicke–Korsakoff syndrome or frontal epilepsy. The neuropsychological dysfunctions underlying mechanisms of confabulation are not well known. We describe two patients with memory impairment and confabulations at the onset speculating about neuropsychological correlates of confabulations and self-awareness. Both patients, a 77-year-old woman and a 57-years-old man, exhibited confabulations as first symptom of cognitive decline. She later developed memory impairment without awareness of her memory deficits and her cognitive and imaging profile suggested an amnesic mild cognitive impairment due to Alzheimer’s disease (AD). Unlike her, he developed a prevalent involvement of frontal functions despite a clear consciousness of his cognitive deficits. However, the clinical diagnostic hypothesis of behavioral variant of frontotemporal dementia was not supported by imaging findings, which suggested AD. Both patients underwent neuropsychological evaluation including the Confabulation Battery. Despite that the exact anatomical correlation of confabulations is still not defined, imaging data shown by our patients is consistent with recent theories according to which at the origin of confabulatory tendency in AD there is an impairment of the connections between crucial hubs in frontal and mediotemporal areas, mainly involving the right hemisphere. Besides, it would be reasonable to hypothesize that self-awareness and confabulations should not be considered as necessarily associated dimensions.
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Pennington C, Duncan G, Ritchie C. Altered awareness of motor symptoms in Parkinson's disease and Dementia with Lewy Bodies: A systematic review. Int J Geriatr Psychiatry 2020; 35:972-981. [PMID: 32525228 DOI: 10.1002/gps.5362] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 06/01/2020] [Accepted: 06/03/2020] [Indexed: 11/12/2022]
Abstract
OBJECTIVES Altered awareness of motor symptoms is reported in people with Parkinson's disease and Dementia with Lewy Bodies, and may adversely affect quality of life and medication concordance. How symptom awareness is influenced by motor and cognitive disease severity, age and medication use is not fully understood. We carried out a systematic review of the literature on motor symptom awareness in Parkinson's disease and Dementia with Lewy Bodies. METHODS Pubmed and Wed of Science were searched for relevant articles published in or prior to March 2019. Data regarding participant demographics, diagnosis, cognitive status, method of assessing awareness and study findings were extracted from relevant publications. RESULTS Sixteen relevant publications were identified. Motor symptom awareness appears to decline over the course of Parkinson's disease. Imaging studies implicate the prefrontal cortex, with different mechanisms involved in hypokinesia and dyskinesia awareness. The hypothesis that people with right hemisphere based disease would have more severely reduced awareness is only weakly supported. Most studies focused on cognitively intact individuals, and on awareness of dyskinesia rather than hypokinesia. CONCLUSIONS Whilst reduced awareness of dyskinesia and to a lesser extent hypokinesia is common, there is a lack of longitudinal data on how awareness changes over time, and how it interacts with global cognitive changes. Motor symptom awareness in Dementia with Lewy Bodies is understudied. Future studies of symptom awareness should include robust assessment of overall cognitive functioning, and use a longitudinal design to elucidate how awareness changes over time. J Am Geriatr Soc 68:-, 2020.
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Affiliation(s)
- Catherine Pennington
- Edinburgh Dementia Prevention, University of Edinburgh, Edinburgh, UK.,Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Gordon Duncan
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Craig Ritchie
- Edinburgh Dementia Prevention, University of Edinburgh, Edinburgh, UK.,Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
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Chaudhry A, Houlden H, Rizig M. Novel fluid biomarkers to differentiate frontotemporal dementia and dementia with Lewy bodies from Alzheimer's disease: A systematic review. J Neurol Sci 2020; 415:116886. [PMID: 32428759 DOI: 10.1016/j.jns.2020.116886] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 04/16/2020] [Accepted: 05/04/2020] [Indexed: 12/12/2022]
Abstract
RATIONALE Frontotemporal dementia (FTD) and dementia with Lewy bodies (DLB) are two common forms of neurodegenerative dementia, subsequent to Alzheimer's disease (AD). AD is the only dementia that includes clinically validated cerebrospinal fluid (CSF) biomarkers in the diagnostic criteria. FTD and DLB often overlap with AD in their clinical and pathological features, making it challenging to differentiate between these conditions. AIM This systematic review aimed to identify if novel fluid biomarkers are useful in differentiating FTD and DLB from AD. Increasing the certainty of the differentiation between dementia subtypes would be advantageous clinically and in research. METHODS PubMed and Scopus were searched for studies that quantified and assessed diagnostic accuracy of novel fluid biomarkers in clinically diagnosed patients with FTD or DLB, in comparison to patients with AD. Meta-analyses were performed on biomarkers that were quantified in 3 studies or more. RESULTS The search strategy yielded 614 results, from which, 27 studies were included. When comparing bio-fluid levels in AD and FTD patients, neurofilament light chain (NfL) level was often higher in FTD, whilst brain soluble amyloid precursor protein β (sAPPβ) was higher in patients with AD. When comparing bio-fluid levels in AD and DLB patients, α-synuclein ensued heterogeneous findings, while the noradrenaline metabolite (MHPG) was found to be lower in DLB. Ratios of Aβ42/Aβ38 and Aβ42/Aβ40 were lower in AD than FTD and DLB and offered better diagnostic accuracy than raw amyloid-β (Aβ) concentrations. CONCLUSIONS Several promising novel biomarkers were highlighted in this review. Combinations of fluid biomarkers were more often useful than individual biomarkers in distinguishing subtypes of dementia. Considering the heterogeneity in methods and results between the studies, further validation, ideally with longitudinal prospective designs with large sample sizes and unified protocols, are fundamental before conclusions can be finalised.
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Affiliation(s)
- Aiysha Chaudhry
- UCL Queen Square Institute of Neurology, University College London, Queen Square, London WC1N 3BG, United Kingdom
| | - Henry Houlden
- UCL Queen Square Institute of Neurology, University College London, Queen Square, London WC1N 3BG, United Kingdom
| | - Mie Rizig
- UCL Queen Square Institute of Neurology, University College London, Queen Square, London WC1N 3BG, United Kingdom.
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Muñoz-Neira C, Tedde A, Coulthard E, Thai NJ, Pennington C. Neural correlates of altered insight in frontotemporal dementia: a systematic review. Neuroimage Clin 2019; 24:102066. [PMID: 31795052 PMCID: PMC6889795 DOI: 10.1016/j.nicl.2019.102066] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 09/14/2019] [Accepted: 11/03/2019] [Indexed: 12/12/2022]
Abstract
Altered insight into disease or specific symptoms is a prominent clinical feature of frontotemporal dementia (FTD). Understanding the neural bases of insight is crucial to help improve FTD diagnosis, classification and management. A systematic review to explore the neural correlates of altered insight in FTD and associated syndromes was conducted. Insight was fractionated to examine whether altered insight into different neuropsychological/behavioural objects is underpinned by different or compatible neural correlates. 6 databases (Medline, Embase, PsycINFO, Web of Science, BIOSIS and ProQuest Dissertations & Theses Global) were interrogated between 1980 and August 2019. 15 relevant papers were found out of 660 titles screened. The studies included suggest that different objects of altered insight are associated with distinctive brain areas in FTD. For example, disease unawareness appears to predominantly correlate with right frontal involvement. In contrast, altered insight into social cognition potentially involves, in addition to frontal areas, the temporal gyrus, insula, parahippocampus and amygdala. Impaired insight into memory problems appears to be related to the frontal lobes, postcentral gyrus, parietal cortex and posterior cingulate. These results reflect to a certain extent those observed in other neurodegenerative conditions like Alzheimer's disease (AD) and also other brain disorders. Nevertheless, they should be cautiously interpreted due to variability in the methodological aspects used to reach those conclusions. Future work should triangulate different insight assessment approaches and brain imaging techniques to increase the understanding of this highly relevant clinical phenomenon in dementia.
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Affiliation(s)
- Carlos Muñoz-Neira
- Research into Memory, Brain sciences and dementia Group (ReMemBr Group), Translational Health Sciences, Bristol Medical School, Faculty of Health Sciences, University of Bristol, UK; Clinical Research and Imaging Centre (CRICBristol), Translational Health Sciences, Bristol Medical School, Faculty of Health Sciences, University of Bristol, UK.
| | - Andrea Tedde
- Department of Clinical and Experimental Medicine, Faculty of Medicine and Surgery, University of Sassari, Italy
| | - Elizabeth Coulthard
- Research into Memory, Brain sciences and dementia Group (ReMemBr Group), Translational Health Sciences, Bristol Medical School, Faculty of Health Sciences, University of Bristol, UK; Clinical Research and Imaging Centre (CRICBristol), Translational Health Sciences, Bristol Medical School, Faculty of Health Sciences, University of Bristol, UK
| | - N Jade Thai
- Clinical Research and Imaging Centre (CRICBristol), Translational Health Sciences, Bristol Medical School, Faculty of Health Sciences, University of Bristol, UK
| | - Catherine Pennington
- Research into Memory, Brain sciences and dementia Group (ReMemBr Group), Translational Health Sciences, Bristol Medical School, Faculty of Health Sciences, University of Bristol, UK; Centre for Dementia Prevention, University of Edinburgh, UK
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Cova I, Grande G, Cucumo V, Ghiretti R, Maggiore L, Galimberti D, Scarpini E, Mariani C, Pomati S. Self-Awareness for Memory Impairment in Amnestic Mild Cognitive Impairment: A Longitudinal Study. Am J Alzheimers Dis Other Demen 2017; 32:401-407. [PMID: 28840743 PMCID: PMC10852863 DOI: 10.1177/1533317517725812] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
AIM To assess memory impairment insight as a predictor of dementia and Alzheimer's disease (AD) in amnestic mild cognitive impairment (MCI). METHODS To verify whether the awareness of memory impairment assessed by Geriatric Depression Scale (GDS) was associated with the risk of progression to dementia and AD in a cohort of MCI, we used a Cox regression model adjusted for age, sex, education, subtypes of amnestic MCI, Mini-Mental State Examination, Cumulative Illness Rating Scale severity index, and apolipoprotein E genotype. RESULTS During a follow-up of 27.7 (20.8) months, 205 (63.3%) of 324 patients with amnestic MCI progressed to dementia, including 141 to AD. No association was found in the unadjusted, partially adjusted (for sociodemographic variables), and fully adjusted multivariate Cox analysis between the awareness of memory impairment and the progression to dementia and AD. DISCUSSION Awareness or anosognosia of memory deficits, identified by GDS, is not useful to predict progression to dementia of patients with amnestic MCI.
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Affiliation(s)
- Ilaria Cova
- Department of Clinical Sciences, Center for Research and Treatment on Cognitive Dysfunctions, Institute of Clinical Neurology, “Luigi Sacco” Hospital, University of Milan, Milan, Italy
| | - Giulia Grande
- Department of Clinical Sciences, Center for Research and Treatment on Cognitive Dysfunctions, Institute of Clinical Neurology, “Luigi Sacco” Hospital, University of Milan, Milan, Italy
| | - Valentina Cucumo
- Department of Clinical Sciences, Center for Research and Treatment on Cognitive Dysfunctions, Institute of Clinical Neurology, “Luigi Sacco” Hospital, University of Milan, Milan, Italy
| | - Roberta Ghiretti
- Department of Clinical Sciences, Center for Research and Treatment on Cognitive Dysfunctions, Institute of Clinical Neurology, “Luigi Sacco” Hospital, University of Milan, Milan, Italy
| | - Laura Maggiore
- Department of Clinical Sciences, Center for Research and Treatment on Cognitive Dysfunctions, Institute of Clinical Neurology, “Luigi Sacco” Hospital, University of Milan, Milan, Italy
| | - Daniela Galimberti
- Neurology Unit, Department of Pathophysiology and Transplantation, University of Milan, Fondazione Ca’ Granda, IRCCS Ospedale Policlinico, Milan, Italy
| | - Elio Scarpini
- Neurology Unit, Department of Pathophysiology and Transplantation, University of Milan, Fondazione Ca’ Granda, IRCCS Ospedale Policlinico, Milan, Italy
| | - Claudio Mariani
- Department of Clinical Sciences, Center for Research and Treatment on Cognitive Dysfunctions, Institute of Clinical Neurology, “Luigi Sacco” Hospital, University of Milan, Milan, Italy
| | - Simone Pomati
- Department of Clinical Sciences, Center for Research and Treatment on Cognitive Dysfunctions, Institute of Clinical Neurology, “Luigi Sacco” Hospital, University of Milan, Milan, Italy
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Sunderaraman P, Cosentino S. Integrating the Constructs of Anosognosia and Metacognition: a Review of Recent Findings in Dementia. Curr Neurol Neurosci Rep 2017; 17:27. [PMID: 28283961 DOI: 10.1007/s11910-017-0734-1] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The current review integrates recent findings regarding the construct of self-awareness in dementia from both clinical and cognitive perspectives. We present the predominant theoretical models of awareness and summarize both traditional and emerging approaches to assessing awareness from clinical and meta-cognitive perspectives. In this review, we focus primarily on findings from recent studies in anosognosia and meta-cognition in the context of neurodegenerative disease with special emphasis on Alzheimer's disease and frontotemporal dementia. Emerging trends in the study of awareness, including examination of the longitudinal course of anosognosia, and investigation of the neural substrates underlying meta-cognitive abilities are addressed. Finally, the practical importance of studying and assessing awareness from both theoretical and clinical angles is emphasized.
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Affiliation(s)
- Preeti Sunderaraman
- Cognitive Neuroscience Division of the Taub Institute for Research on Alzheimer's Disease, Columbia University Medical Center, New York, NY, USA.,Aging Brain, G.H. Sergievsky Center, Columbia University Medical Center, New York, NY, USA.,Taub Institute, Columbia University Medical Center, 630 West 168th St., P&S Box 16, New York, NY, 10032, USA
| | - Stephanie Cosentino
- Cognitive Neuroscience Division of the Taub Institute for Research on Alzheimer's Disease, Columbia University Medical Center, New York, NY, USA. .,Aging Brain, G.H. Sergievsky Center, Columbia University Medical Center, New York, NY, USA. .,Department of Neurology, Columbia University Medical Center, New York, NY, USA. .,Taub Institute, Columbia University Medical Center, 630 West 168th St., P&S Box 16, New York, NY, 10032, USA.
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