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000910951 1001_ $$0P:(DE-HGF)0$$aMaier, Franziska$$b0$$eCorresponding author
000910951 245__ $$aImpaired self-awareness of cognitive deficits in Parkinson's disease relates to cingulate cortex dysfunction
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000910951 520__ $$aBackgroundImpaired 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.KeywordsAnosognosiaimpaired self-awarenessmild cognitive impairmentmultimodal neuroimagingParkinson's disease
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000910951 7001_ $$0P:(DE-HGF)0$$aGreuel, Andrea$$b1
000910951 7001_ $$0P:(DE-HGF)0$$aHoock, Marius$$b2
000910951 7001_ $$0P:(DE-HGF)0$$aKaur, Rajbir$$b3
000910951 7001_ $$0P:(DE-HGF)0$$aTahmasian, Masoud$$b4
000910951 7001_ $$0P:(DE-HGF)0$$aSchwartz, Frank$$b5
000910951 7001_ $$0P:(DE-HGF)0$$aCsoti, Ilona$$b6
000910951 7001_ $$0P:(DE-HGF)0$$aJessen, Frank$$b7
000910951 7001_ $$0P:(DE-Juel1)177611$$aDrzezga, Alexander$$b8
000910951 7001_ $$0P:(DE-HGF)0$$avan Eimeren, Thilo$$b9
000910951 7001_ $$0P:(DE-HGF)0$$aTimmermann, Lars$$b10
000910951 7001_ $$0P:(DE-HGF)0$$aEggers, Carsten$$b11
000910951 773__ $$0PERI:(DE-600)1470300-2$$a10.1017/S0033291721002725$$gp. 1 - 10$$p1 - 10$$tPsychological medicine$$v1$$x0033-2917$$y2021
000910951 8564_ $$uhttps://juser.fz-juelich.de/record/910951/files/Impaired%20self-awareness.pdf$$yOpenAccess
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000910951 9101_ $$0I:(DE-HGF)0$$6P:(DE-HGF)0$$a  Department of Psychiatry and Psychotherapy, Medical Faculty and University Hospital Cologne, University of Cologne, Cologne, Germany $$b0
000910951 9101_ $$0I:(DE-HGF)0$$6P:(DE-HGF)0$$a Department of Neurology, University Hospital Giessen and Marburg, Marburg, Germany$$b2
000910951 9101_ $$0I:(DE-HGF)0$$6P:(DE-HGF)0$$a Department of Neurology, University Hospital Giessen and Marburg, Marburg, Germany$$b3
000910951 9101_ $$0I:(DE-HGF)0$$6P:(DE-HGF)0$$a  Institute of Medical Science and Technology, Shahid Beheshti University, Tehran, Iran $$b4
000910951 9101_ $$0I:(DE-HGF)0$$6P:(DE-HGF)0$$a Department of Neurology, Hospital of the Brothers of Mercy, Trier, Germany$$b5
000910951 9101_ $$0I:(DE-HGF)0$$6P:(DE-HGF)0$$a Gertrudis Clinic, Parkinson-Center, Leun-Biskirchen, Germany$$b6
000910951 9101_ $$0I:(DE-HGF)0$$6P:(DE-HGF)0$$a Department of Psychiatry and Psychotherapy, Medical Faculty and University Hospital Cologne, University of Cologne, Cologne, Germany German Center for Neurodegenerative Disorders (DZNE), Bonn, Germany $$b7
000910951 9101_ $$0I:(DE-HGF)0$$6P:(DE-Juel1)177611$$a German Center for Neurodegenerative Disorders (DZNE), Bonn, Germany$$b8
000910951 9101_ $$0I:(DE-HGF)0$$6P:(DE-Juel1)177611$$a Department of Nuclear Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, Cologne, Germany$$b8
000910951 9101_ $$0I:(DE-HGF)0$$6P:(DE-Juel1)177611$$a Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-2), Research Center Jülich, Jülich, Germany$$b8
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000910951 9101_ $$0I:(DE-HGF)0$$6P:(DE-HGF)0$$a  Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-2), Research Center Jülich, Jülich, Germany Department of Neurology, Medical Faculty and University Hospital Cologne, University of Cologne, Cologne, Germany Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Center Jülich,Jülich, Germany $$b9
000910951 9101_ $$0I:(DE-HGF)0$$6P:(DE-HGF)0$$a Department of Neurology, University Hospital Giessen and Marburg, Marburg, Germany$$b10
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