Session Information
Date: Wednesday, September 25, 2019
Session Title: Neuroimaging
Session Time: 1:15pm-2:45pm
Location: Les Muses Terrace, Level 3
Objective: To discover the neural basis of impaired self-awareness of cognitive deficits (ISA-cog) in Parkinson’s disease (PD) patients with mild cognitive impairment (MCI).
Background: Anosognosia or ISA-cog has been rarely investigated in PD, although cognitive impairments may appear early in the course of the disease. In Alzheimer’s Disease (AD), numerous studies exist and demonstrate that ISA-cog can be present in patients with MCI and dementia. In AD, the cingulate cortex has been related to ISA-cog suggesting impaired error detection.
Method: We examined 63 PD patients and 30 age- and education-matched healthy controls. Depressed and/or demented patients were excluded. Patient’s cognitive state (normal cognition or MCI) was examined according to MDS Level II criteria. A standard deviation (SD) of ≤ 1.5 was considered as impairment. ISA-cog was determined by comparing z-scores for objective tests with subjective questionnaires. To examine neuroimaging correlates of ISA-cog, 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) was conducted. Glucose metabolism was analyzed in a whole brain approach.
Results: No differences in ISA-cog were found when all PD patients and controls were compared, although patients were significantly more cognitively impaired. When PD patients were classified, 40 had normal cognition (PD-NC) and 23 had MCI. MCI patients showed significantly more ISA-cog compared to controls and PD-NC. When FDG-PET images were analyzed, no significant correlation was found between ISA-cog and glucose metabolism in controls and PD-NC. When all PD patients were examined, lower FDG-metabolism was significantly associated with more ISA-cog in the right superior medial frontal gyrus and the right anterior cingulate cortex (FWE-corrected p<.001). When MCI patients were analyzed, more ISA-cog was significantly related to a decreased FDG-metabolism in the right superior temporal lobe and the right insula (FWE-corrected p=.023) as well as in the right mid-cingulate cortex (FWE-corrected p=.002).
Conclusion: Similarly to AD, the cingulate cortex seems to play a crucial role in ISA-cog in PD patients with MCI. Additionally, the right superior temporal lobe and the right insula might be involved.
To cite this abstract in AMA style:
F. Maier, A. Greuel, M. Hoock, M. Tahmasian, F. Jessen, I. Csoti, L. Timmermann, C. Eggers. Imaging correlates of impaired self-awareness of cognitive deficits in Parkinson’s disease [abstract]. Mov Disord. 2019; 34 (suppl 2). https://www.mdsabstracts.org/abstract/imaging-correlates-of-impaired-self-awareness-of-cognitive-deficits-in-parkinsons-disease/. Accessed May 14, 2025.« Back to 2019 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/imaging-correlates-of-impaired-self-awareness-of-cognitive-deficits-in-parkinsons-disease/