Mnemonic monitoring in anosognosia for memory loss.

Abstract

Objective: Anosognosia, or unawareness, for memory loss has been proposed to underlie cognitive functions such as memory and executive function. However, there is an inconsistent association between these constructs. Recent studies have shown that compromise ongoing self-monitoring of one's memory associates with anosognosia for memory loss. Yet to date it is unclear which memory monitoring mechanisms are impaired in these patients. In this study, we examined the extent to which temporal monitoring or orbitofrontal reality filtering (e.g., ability to monitor the temporal relevance of a memory) and source monitoring (e.g., the ability to distinguish which memories stem from internal as opposed to external sources) are associated with awareness of memory deficits. Methods: A total of 35 patients (M=69 years; M=14 years of education) with memory difficulties following a stroke were recruited from outpatient clinics. Patients were assessed with measures of self-awareness of memory difficulties, cognitive abilities and two experimental paradigms assessing source and temporal monitoring. Results and conclusion: Results showed that patients unaware of their memory difficulties were more likely to externalize the source of their memories. Specifically, those unaware of their deficits were more likely to assign an external source to memories that were internally produced (e.g., imagined). No differences were observed in relation to temporal monitoring between patients aware and unaware of their deficits. This study informs current theoretical models of self-awareness of memory loss. Future studies should attempt to replicate these findings and explore different memory monitoring mechanisms in relation to anosognosia for memory loss.

Syndromes of limb apraxia: Developmental and acquired disorders of skilled movements.

“…Prospectively, deficient mechanisms that may be predictive for anosognosia in limb apraxia should be explored. More generally, discussed mechanisms for unawareness may apply to anosognosia in limb apraxia, for example, difficulties with reality monitoring (e.g., of the action) and a failure to detect discrepancies between the predicted and the estimated actual state (Chapman et al, 2020;Saj et al, 2014).…”

Self- and Other-Evaluation in Alzheimer’s Disease

“…Anosognosia represents a complex and multifaceted phenomenon [9,10], associated with impairment in different cognitive mechanisms (e.g., [11]) and neuroanatomical networks [10,12], also being impacted by psychosocial factors, such as culture [1] and premorbid personality [13]. Anosognosia in dementia has also been known to vary depending on illness severity [1], but this relationship is nonlinear [14].The heterogeneity of anosognosia, particularly in AD [7], has been incorporated into theoretical models of the phenomenon [15], which try to explain, for instance, how patients may exhibit unawareness of deficits in one domain, but not in another, or how similar clinical presentations may have distinct etiologies.…”