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@ARTICLE{Maier:910951,
      author       = {Maier, Franziska and Greuel, Andrea and Hoock, Marius and
                      Kaur, Rajbir and Tahmasian, Masoud and Schwartz, Frank and
                      Csoti, Ilona and Jessen, Frank and Drzezga, Alexander and
                      van Eimeren, Thilo and Timmermann, Lars and Eggers, Carsten},
      title        = {{I}mpaired self-awareness of cognitive deficits in
                      {P}arkinson's disease relates to cingulate cortex
                      dysfunction},
      journal      = {Psychological medicine},
      volume       = {1},
      issn         = {0033-2917},
      address      = {[S.l.]},
      publisher    = {Proquest},
      reportid     = {FZJ-2022-04279},
      pages        = {1 - 10},
      year         = {2021},
      abstract     = {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},
      cin          = {INM-2 / INM-3},
      ddc          = {610},
      cid          = {I:(DE-Juel1)INM-2-20090406 / I:(DE-Juel1)INM-3-20090406},
      pnm          = {5252 - Brain Dysfunction and Plasticity (POF4-525) / 5253 -
                      Neuroimaging (POF4-525)},
      pid          = {G:(DE-HGF)POF4-5252 / G:(DE-HGF)POF4-5253},
      typ          = {PUB:(DE-HGF)16},
      UT           = {WOS:000785644900001},
      doi          = {10.1017/S0033291721002725},
      url          = {https://juser.fz-juelich.de/record/910951},
}