A Single-Photon Emission Computed Tomographic Study of Anosognosia in Alzheimer's Disease

Starkstein, Sergio E.; Vázquez, Silvia; Migliorelli, R.; Tesón, Alejandra; Sabe, Liliana; Leiguarda, R

doi:10.1001/archneur.1995.00540280105024

Cited by 136 publications

(102 citation statements)

References 16 publications

(4 reference statements)

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“…Since self-monitoring is supposed to be deeply dependent on the prefrontal lobes, previous neuropsychological and neuroimaging studies have naturally found that underawareness is associated with frontal dysfunction (Mangone et al 1991;Reed et al 1993;Lopez et al 1994;Michon et al 1994;Starkstein et al 1995Starkstein et al , 1997Ott et al 1996). Specifically, the prediction/postdictions method is thought to require on-line processes dependent on frontal lobe integrity (Correa et al 1996).…”

Section: Toward a Neural Substrate For Awarenessmentioning

confidence: 99%

Memory Impairment and Awareness of Memory Deficits in Early-Stage Alzheimer's Disease

Mimura

2008

Tohoku J. Exp. Med.

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In addition to their memory impairment, individuals with Alzheimer's disease (AD) often suffer from deficits in self-awareness. Awareness of memory deficits or metamemory is a multifaceted function, comprising on-line self-monitoring, generalized self-beliefs of memory efficacy, and generalized knowledge about memory functions. Awareness of memory problems in early-stage AD is a matter of clinical importance from a humanistic point of view, because higher levels of awareness may be associated with better future outcomes. Current methods of measuring awareness tend to fall into two categories, i.e., to introduce a questionnaire assessing patient/caregiver discrepancies; or to ask a patient to prospectively predict or retrospectively postdict their own memory performances. Characteristics of each measure as well as relationship between the two measures were discussed. For the performance prediction/postdiction paradigm, we used recognition memory of auditory verbal learning tests and awareness of memory deficits were examined in 24 individuals with early-stage AD. In addition to their significantly impaired recognition memory, individuals with AD displayed underawareness of memory deficits even at this early stage. They retrospectively overestimated memory performance after actual performance, but appeared to benefit from feedback and displayed intact on-line awareness of memory dysfunction, leading to normal prediction of the second session. However, individuals with AD again failed to retrospectively incorporate incidents of memory failure into generalized self-belief systems. Brain/behavior correlational analyses suggest that the prefrontal cortex and posterior dorsomedial regions including the precuneus may be involved in selfawareness.awareness; dementia; SPECT; frontal lobe; precuneus.Tohoku

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Section: Toward a Neural Substrate For Awarenessmentioning

confidence: 99%

Memory Impairment and Awareness of Memory Deficits in Early-Stage Alzheimer's Disease

Mimura

2008

Tohoku J. Exp. Med.

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“…Studies relating anosognosia to brain activity have shown a decrease of right lateral frontal and parietal activity in AD patients with anosognosia (Leys et al, 1989;Starkstein et al, 1995;Derouesne et al, 1999). In a theoretical model, the ''conscious awareness system'' was suggested to depend on inferior parietal and posterior cingulate cortex (McGlynn and Schacter, 1989).…”

Section: Behavioral Measures Of Anosognosia In Admentioning

confidence: 99%

Two aspects of impaired consciousness in Alzheimer's disease

Salmon

Ruby

Perani

et al. 2005

Progress in Brain Research

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“…This is borne out in empirical studies through both the terminology used in referring to insight and the approaches taken to evaluate it. Thus in the case of the former, the phenomenon of insight is couched in the language of the theoretical structure underlying the discipline and includes, for example, loss of insight [49], anosognosia [18,51], lack of awareness [3,52], denial of illness [21,53], etc. Similarly, the methods of evaluating insight by researchers reflect their specific theoretical background, and this may account for the diversity in type of measures used, e.g., specific cognitive tasks [19], questionnaires [20], or interviews [21].…”

Section: Dementiamentioning

confidence: 99%

The ‘Object’ of Insight Assessment: Relationship to Insight ‘Structure’

Marková

Berríos

2001

Psychopathology

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Insight is a relational or ‘intentional’ concept, i.e., it is only understood in terms of its relation to something; and that ‘something’ is the ‘object’ of insight. In clinical practice, the ‘object’ of insight thus generally refers to a particular mental or physical state (e.g., mental illness, neuropsychological deficit) in relation to which insight is being assessed. It is argued in this paper that the ‘object’ of insight plays a crucial role in shaping or determining the sort of insight that is elicited in clinical practice (i.e., the phenomenon of insight). Three ways in which the ‘object’ of insight can shape the clinical phenomenon of insight are discussed. One concerns the conceptual background in which the ‘object’ is embedded and which is likely to impose a similar structure onto the phenomenon of insight. Another is the semantic category to which the ‘object’ of insight belongs and which will imprint its particular structure on the phenomenon of insight. Yet another concerns the specific nature of the ‘object’ which itself will shape the insight phenomenon elicited. This carries implications for research on insight, since insight tends to be explored in relation to a variety of ‘objects’. Phenomena of insight in relation to different ‘objects’ are likely to vary in structure, and this, in turn, has consequences for mechanisms underlying insight in each case. Understanding more about the nature and contribution of the ‘object’ of insight in the insight-‘object’ relationship will help to delineate separate insight phenomena and achieve consistency in empirical studies on insight.

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A Single-Photon Emission Computed Tomographic Study of Anosognosia in Alzheimer's Disease

Cited by 136 publications

References 16 publications

Memory Impairment and Awareness of Memory Deficits in Early-Stage Alzheimer's Disease

Memory Impairment and Awareness of Memory Deficits in Early-Stage Alzheimer's Disease

Two aspects of impaired consciousness in Alzheimer's disease

The ‘Object’ of Insight Assessment: Relationship to Insight ‘Structure’

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