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Cognitive and anatomical correlates of anosognosia in amnestic mild cognitive impairment and early-stage Alzheimer's disease

Published online by Cambridge University Press:  26 October 2016

Gulben Senturk ,
Basar Bilgic ,
Ali Bilgin Arslan ,
Ali Bayram Open the ORCID record for Ali Bayram [Opens in a new window] ,
Hasmet Hanagasi ,
Hakan Gurvit  and
Murat Emre
Gulben Senturk
Affiliation:
Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
Basar Bilgic*
Affiliation:
Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey Hulusi Behcet Life Sciences Research Center, Istanbul University, Istanbul, Turkey
Ali Bilgin Arslan
Affiliation:
Department of Cognitive, Linguistic and Psychological Sciences, Brown University, Providence, USA
Ali Bayram
Affiliation:
Hulusi Behcet Life Sciences Research Center, Istanbul University, Istanbul, Turkey Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey
Hasmet Hanagasi
Affiliation:
Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
Hakan Gurvit
Affiliation:
Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
Murat Emre
Affiliation:
Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
*
Correspondence should be addressed to: Basar Bilgic, Dept. of Neurology, Istanbul Faculty of Medicine, Istanbul University, 34093 Capa, Istanbul, Turkey. Phone: +902124142000; Fax: +902125338575. Email: bilgicb@gmail.com.
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Abstract

Background:

Anosognosia is a common feature in Alzheimer's disease (AD). The brain substrates of anosognosia are not fully understood, and less is known about the cognitive substrates of anosognosia in prodromal and early stages of AD.

Methods:

Fourty-seven patients with amnestic-type mild cognitive impairment (aMCI) (n = 26) and early-stage AD (n = 21) were included, and Clinical Insight Rating Scale and Anosognosia Questionnaire for Dementia (AQ-D) were used to assess anosognosia. A detailed neuropsychological battery was administered; each patient underwent a structural magnetic resonance imaging (MRI). Correlation between anosognosia and performance in individual cognitive domains as well as correlation between anosognosia and cortical thickness values in regions of interest were assessed.

Results:

Performance of the anosognosic patients in Digit Ordering Test (DOT), Digit Span Backwards, and Clock Drawing Test (CDT) was significantly worse compared to non-anosognosic patients in the total study population and in the aMCI subgroup but not in AD group. AQ-D scores negatively correlated with Mini-Mental State Examination (MMSE), California Verbal Learning Test (CVLT), Digit Span Backwards and CDT scores in total group and MMSE, CVLT, DOT, and Digit Span Backwards scores in the aMCI group. No significant correlations were found between cortical thickness measurements and AQ-D scores in any of the patient populations.

Conclusions:

Anosognosia was associated with episodic memory, working memory, and executive functions in the total population and aMCI group, but no association was found in early-stage AD patients. Anosognosia in the early stages of AD may be related with non-structural changes such as hypoconnectivity rather than structural changes.

Keywords

Alzheimer's diseasemild cognitive impairment
Type
Research Article
Information
International Psychogeriatrics , Volume 29 , Issue 2 , February 2017 , pp. 293 - 302
Copyright
Copyright © International Psychogeriatric Association 2016 

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