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Cognitive anosognosia is associated with frontal dysfunction and lower depression in Parkinson’s disease
Author(s) -
Yoo H. S.,
Chung S. J.,
Lee Y. H.,
Ye B. S.,
Sohn Y. H.,
Lee P. H.
Publication year - 2020
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.14188
Subject(s) - anosognosia , cognition , montreal cognitive assessment , stroop effect , beck depression inventory , psychiatry , clinical psychology , medicine , dementia , effects of sleep deprivation on cognitive performance , depression (economics) , psychology , disease , cognitive impairment , anxiety , economics , macroeconomics
Background and purpose Anosognosia refers to a deficit of self‐awareness or impaired insight for cognitive and behavioral problems. Cognitive anosognosia was explored in de novo patients with Parkinson’s disease (PD) and its relationship to cognitive function and neuropsychiatric symptoms was investigated. Methods The cross‐sectional study enrolled 340 drug‐naïve patients with PD. According to the presence of mild cognitive impairment (MCI) and subjective cognitive complaint, patients were classified as patients with cognitive anosognosia (PD‐CA, n = 74), with normal cognitive recognition (PD‐NR, n = 184) or with cognitive underestimation (PD‐CU, n = 82). After controlling for covariates, cognitive performance and neuropsychiatric symptoms were compared between the PD groups. Results Cognitive anosognosia was found in 21.8% of patients with de novo PD. The PD‐CA group showed poorer performance in all cognitive domains except for attention. Amongst PD patients with MCI, those with cognitive anosognosia showed lower composite z ‐scores in the Stroop color reading test than those without. The Beck Depression Inventory score in the PD‐NR group was lower than that in the PD‐CU group and higher than that in the PD‐CA group. The Cognitive Complaints Interview score mediated the association between cognitive anosognosia and Beck Depression Inventory score. Conclusions Cognitive anosognosia in PD was associated with greater frontal dysfunction and lower depression. Since cognitive anosognosia has a harmful impact on PD patients and their caregivers due to overestimation of their abilities in everyday life, early identification of cognitive anosognosia in PD is important in management and prognosis.