What Are the Neural Correlates of Meta-cognition and Anosognosia in Alzheimer's Disease? A Systematic Review

Overview

Journal Neurobiol Aging

Publisher Elsevier

Specialties Geriatrics
Neurology
Physiology

Date 2020 Jul 18

PMID 32679396

Citations 26

Authors

Brendan Hallam

Justin Chan

Sergi Gonzalez Costafreda

Rohan Bhome

Jonathan Huntley

Affiliations

Soon will be listed here.

Abstract

Awareness of one's own cognitive processes (metacognition) or of one's own illness or deficits (anosognosia) can be impaired in people with Alzheimer's disease (AD). The neural correlates of anosognosia within AD remain inconclusive. Understanding anosognosia is of importance because of its impact on carer burden and increased institutionalization. A systematic review of structural and functional neuroimaging studies was conducted to identify specific brain regions associated with anosognosia within AD. Thirty-two studies were included in the systematic review. Reduced gray matter density, cerebral blood flow, and hypometabolism in 8 key regions were significantly associated with increased anosognosia scores in people with AD. The most frequently associated regions were the inferior frontal gyrus, anterior cingulate cortex, and medial temporal lobe. Other key regions include the superior frontal gyrus, medial frontal gyrus, orbitofrontal cortex, posterior cingulate cortex, and the insula. Identifying brain regions associated with anosognosia can aid understanding and identification of anosognosia in people with AD and potentially facilitate improvements in care.

Citing Articles

Alteration in temporal-cerebellar effective connectivity can effectively distinguish stable and progressive mild cognitive impairment.

Xue C, Zheng D, Ruan Y, Guo W, Hu J Front Aging Neurosci. 2024; 16:1442721.

PMID: 39267723 PMC: 11390694. DOI: 10.3389/fnagi.2024.1442721.

Multi-modal Neuroimaging Phenotyping of Mnemonic Anosognosia in the Aging Brain.

Bueicheku E, Diez I, Gagliardi G, Kim C, Mimmack K, Sepulcre J Commun Med (Lond). 2024; 4(1):65.

PMID: 38580832 PMC: 10997795. DOI: 10.1038/s43856-024-00497-9.

Multimodal active subspace analysis for computing assessment oriented subspaces from neuroimaging data.

Batta I, Abrol A, Calhoun V J Neurosci Methods. 2024; 406:110109.

PMID: 38494061 PMC: 11100582. DOI: 10.1016/j.jneumeth.2024.110109.

Consensus on rapid screening for prodromal Alzheimer's disease in China.

Huang L, Li Q, Lu Y, Pan F, Cui L, Wang Y Gen Psychiatr. 2024; 37(1):e101310.

PMID: 38313393 PMC: 10836380. DOI: 10.1136/gpsych-2023-101310.

Self-supervised multimodal learning for group inferences from MRI data: Discovering disorder-relevant brain regions and multimodal links.

Fedorov A, Geenjaar E, Wu L, Sylvain T, DeRamus T, Luck M Neuroimage. 2023; 285:120485.

PMID: 38110045 PMC: 10872501. DOI: 10.1016/j.neuroimage.2023.120485.

References

Turro-Garriga O, Garre-Olmo J, Rene-Ramirez R, Calvo-Perxas L, Gascon-Bayarri J, Conde-Sala J . Consequences of Anosognosia on the Cost of Caregivers' Care in Alzheimer's Disease. J Alzheimers Dis. 2016; 54(4):1551-1560. DOI: 10.3233/JAD-160419. View

Hornberger M, Yew B, Gilardoni S, Mioshi E, Gleichgerrcht E, Manes F . Ventromedial-frontopolar prefrontal cortex atrophy correlates with insight loss in frontotemporal dementia and Alzheimer's disease. Hum Brain Mapp. 2012; 35(2):616-26. PMC: 6869805. DOI: 10.1002/hbm.22200. View

Cosentino S, Metcalfe J, Cary M, de Leon J, Karlawish J . Memory Awareness Influences Everyday Decision Making Capacity about Medication Management in Alzheimer's Disease. Int J Alzheimers Dis. 2011; 2011:483897. PMC: 3109698. DOI: 10.4061/2011/483897. View

Ma Y, Eidelberg D . Functional imaging of cerebral blood flow and glucose metabolism in Parkinson's disease and Huntington's disease. Mol Imaging Biol. 2007; 9(4):223-33. PMC: 4455550. DOI: 10.1007/s11307-007-0085-4. View

Leech R, Braga R, Sharp D . Echoes of the brain within the posterior cingulate cortex. J Neurosci. 2012; 32(1):215-22. PMC: 6621313. DOI: 10.1523/JNEUROSCI.3689-11.2012. View

Anthony M, Lin F . A Systematic Review for Functional Neuroimaging Studies of Cognitive Reserve Across the Cognitive Aging Spectrum. Arch Clin Neuropsychol. 2017; 33(8):937-948. PMC: 6246379. DOI: 10.1093/arclin/acx125. View

Genon S, Simon J, Bahri M, Collette F, Souchay C, Jaspar M . Relating pessimistic memory predictions to Alzheimer's disease brain structure. Cortex. 2016; 85:151-164. DOI: 10.1016/j.cortex.2016.09.014. View

Bertrand E, Azar M, Rizvi B, Brickman A, Huey E, Habeck C . Cortical thickness and metacognition in cognitively diverse older adults. Neuropsychology. 2018; 32(6):700-710. PMC: 6126945. DOI: 10.1037/neu0000458. View

Therriault J, Ng K, Pascoal T, Mathotaarachchi S, Kang M, Struyfs H . Anosognosia predicts default mode network hypometabolism and clinical progression to dementia. Neurology. 2018; 90(11):e932-e939. PMC: 5858945. DOI: 10.1212/WNL.0000000000005120. View

10.

Guerrier L, Le Men J, Gane A, Planton M, Salabert A, Payoux P . Involvement of the Cingulate Cortex in Anosognosia: A Multimodal Neuroimaging Study in Alzheimer's Disease Patients. J Alzheimers Dis. 2018; 65(2):443-453. PMC: 6130407. DOI: 10.3233/JAD-180324. View

11.

Harwood D, Sultzer D, Feil D, Monserratt L, Freedman E, Mandelkern M . Frontal lobe hypometabolism and impaired insight in Alzheimer disease. Am J Geriatr Psychiatry. 2005; 13(11):934-41. DOI: 10.1176/appi.ajgp.13.11.934. View

12.

Ott B, Noto R, Fogel B . Apathy and loss of insight in Alzheimer's disease: a SPECT imaging study. J Neuropsychiatry Clin Neurosci. 1996; 8(1):41-6. DOI: 10.1176/jnp.8.1.41. View

13.

Fleming S, Lau H . How to measure metacognition. Front Hum Neurosci. 2014; 8:443. PMC: 4097944. DOI: 10.3389/fnhum.2014.00443. View

14.

Amanzio M, Torta D, Sacco K, Cauda F, DAgata F, Duca S . Unawareness of deficits in Alzheimer's disease: role of the cingulate cortex. Brain. 2011; 134(Pt 4):1061-76. DOI: 10.1093/brain/awr020. View

15.

Mimura M, Yano M . Memory impairment and awareness of memory deficits in early-stage Alzheimer's disease. Rev Neurosci. 2006; 17(1-2):253-66. DOI: 10.1515/revneuro.2006.17.1-2.253. View

16.

Fujimoto H, Matsuoka T, Kato Y, Shibata K, Nakamura K, Yamada K . Brain regions associated with anosognosia for memory disturbance in Alzheimer's disease: a magnetic resonance imaging study. Neuropsychiatr Dis Treat. 2017; 13:1753-1759. PMC: 5505610. DOI: 10.2147/NDT.S139177. View

17.

SELTZER B, Vasterling J, Yoder J, Thompson K . Awareness of deficit in Alzheimer's disease: relation to caregiver burden. Gerontologist. 1997; 37(1):20-4. DOI: 10.1093/geront/37.1.20. View

18.

Turro-Garriga O, Garre-Olmo J, Vilalta-Franch J, Conde-Sala J, de Gracia Blanco M, Lopez-Pousa S . Burden associated with the presence of anosognosia in Alzheimer's disease. Int J Geriatr Psychiatry. 2012; 28(3):291-7. DOI: 10.1002/gps.3824. View

19.

Starkstein S . Anosognosia in Alzheimer's disease: diagnosis, frequency, mechanism and clinical correlates. Cortex. 2014; 61:64-73. DOI: 10.1016/j.cortex.2014.07.019. View

20.

Schulz K, Sydekum E, Krueppel R, Engelbrecht C, Schlegel F, Schroter A . Simultaneous BOLD fMRI and fiber-optic calcium recording in rat neocortex. Nat Methods. 2012; 9(6):597-602. DOI: 10.1038/nmeth.2013. View