TY  - JOUR
AU  - Maier, Franziska
AU  - Greuel, Andrea
AU  - Hoock, Marius
AU  - Kaur, Rajbir
AU  - Tahmasian, Masoud
AU  - Schwartz, Frank
AU  - Csoti, Ilona
AU  - Jessen, Frank
AU  - Drzezga, Alexander
AU  - van Eimeren, Thilo
AU  - Timmermann, Lars
AU  - Eggers, Carsten
TI  - Impaired self-awareness of cognitive deficits in Parkinson's disease relates to cingulate cortex dysfunction
JO  - Psychological medicine
VL  - 1
SN  - 0033-2917
CY  - [S.l.]
PB  - Proquest
M1  - FZJ-2022-04279
SP  - 1 - 10
PY  - 2021
AB  - BackgroundImpaired 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
LB  - PUB:(DE-HGF)16
UR  - <Go to ISI:>//WOS:000785644900001
DO  - DOI:10.1017/S0033291721002725
UR  - https://juser.fz-juelich.de/record/910951
ER  -