Impaired self-awareness of cognitive deficits in Parkinson's disease relates to cingulate cortex dysfunction

Abstract Background Impaired 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. Methods We 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. Results PD-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. Conclusions Similar 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.

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Resting regional cerebral glucose metabolism in advanced Parkinson's disease studied in theoff andon conditions with [18F]FDG-PET

Movement Disorders ◽

10.1002/mds.1212 ◽

2001 ◽

Vol 16 (6) ◽

pp. 1014-1022 ◽

Cited By ~ 81

Author(s):

Georg Berding ◽

Per Odin ◽

David J. Brooks ◽

Guido Nikkhah ◽

Cordula Matthies ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Glucose Metabolism ◽

Fdg Pet ◽

Cerebral Glucose Metabolism ◽

Advanced Parkinson’S Disease ◽

18F Fdg ◽

Regional Cerebral Glucose Metabolism

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Study on brain glucose metabolic networks in Parkinson’s disease patients with visual spatial dysfunction by 18F-FDG PET imaging

Traditional Medicine and Modern Medicine ◽

10.1142/s2575900018500015 ◽

2018 ◽

Vol 01 (01) ◽

pp. 27-31 ◽

Cited By ~ 1

Author(s):

Haibo Tan ◽

Xiuming Li ◽

Kai Wei ◽

Yihui Guan

Keyword(s):

Parkinson’S Disease ◽

Glucose Metabolism ◽

Pet Imaging ◽

Fdg Pet ◽

Healthy Controls ◽

Brain Glucose ◽

Brain Glucose Metabolism ◽

Temporal Lobes ◽

Visual Spatial ◽

The Brain

Aim: To assess the changes of brain glucose metabolism and abnormal intracerebral loop in early Parkinson’s disease (PD) patients with visual spatial dysfunction by [Formula: see text]F-fluorodeoxyglucose ([Formula: see text]F-FDG) positron emission tomography (PET) imaging. Materials and Methods: This study includes three groups: early PD patients with visual spatial dysfunction ([Formula: see text]), early PD patients without visual spatial dysfunction ([Formula: see text]) and healthy controls ([Formula: see text]). Resting-state [Formula: see text]F-FDG PET was performed to obtain the imaging of brain glucose metabolism. Statistical Parametric Mapping (SPM) was used for data analyses to compare the brain glucose metabolic changes among different groups. Results: Compared with the healthy controls, early PD patients (with/without visual spatial dysfunction) showed hypermetabolism in putamen, globus pallidus, thalamus, pons, cerebellum and primary motor cortex, and hypometabolism in part of the occipital and temporal lobes. Compared with early PD patients without visual spatial dysfunction, those with visual spatial dysfunction further showed hypometabolism in visual regions including bilateral lateral prefrontal cortices and posterior parietal lobules, besides occipital and temporal lobes. Conclusion: The occurrence of abnormal glucose metabolism in the brain visual processing areas was closely associated with visual spatial dysfunction in PD patients.

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Clinical utility of the INECO Frontal Screening for detecting Mild Cognitive Impairment in Parkinson’s disease

Dementia & Neuropsychologia ◽

10.1590/1980-57642018dn13-040005 ◽

2019 ◽

Vol 13 (4) ◽

pp. 394-402

Author(s):

Yunier Broche-Pérez ◽

Danay Bartuste-Marrer ◽

Miriam Batule-Domínguez ◽

Filiberto Toledano-Toledano

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Sensitivity And Specificity ◽

Cognitive Deficits ◽

Healthy Controls ◽

Study Results ◽

Adequate Accuracy ◽

Low Performance

ABSTRACT Cognitive deficits in Parkinson’s disease typically affect executive functions. Recently, the concept of Mild Cognitive Impairment (MCI) has been related to PD (PD-MCI). PD-MCI is considered a transition phase to Parkinson’s disease Dementia. Therefore, it is important to identify PD-MCI in a reliable way. Objective: To evaluate the sensitivity and specificity of the INECO Frontal Screening (IFS) in detecting cognitive deficits in PD-MCI. Additionally, we compare the IFS and the Addenbrook Cognitive Examination Revised (ACE-R) between three groups; PD-MCI, MCI, and controls. Methods: The IFS and ACE-R were administered to 36 patients with PD-MCI, 31 with MCI (amnestic-multidomain subtype) and 92 healthy controls. Sensitivity and specificity were determined using ROC analysis. The groups were compared using one-way analysis of variance. Results: The IFS had adequate accuracy in differentiating patients with PD-MCI from healthy controls (AUC=0.77, sensitivity=0.82, specificity=0.77), and good accuracy in differentiating PD-MCI from MCI patients (AUC=0.80, sensitivity=0.82, specificity=0.61). However the IFS had low accuracy in differentiating MCI patients from healthy controls (AUC=0.47, sensitivity=0.52, specificity=0.41). On the ACE-R, the PD-MCI group had low performance in Fluency and Language. Only patients with PD-MCI had difficulties on the IFS, specifically in inhibitory control and visual working memory. This dysexecutive profile explains the sensitivity and specificity values found in the IFS. Conclusion: The present study results suggest that the IFS is a suitable screening tool for exploring cognitive dysfunction in PD-MCI, especially in those patients with a dysexecutive profile.

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Neural correlates of self‐awareness of cognitive deficits in nondemented patients with Parkinson’s disease

European Journal of Neurology ◽

10.1111/ene.15095 ◽

2021 ◽

Author(s):

Han Soo Yoo ◽

Hyeokjin Kwon ◽

Seok Jong Chung ◽

Young H. Sohn ◽

Jong‐Min Lee ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cognitive Deficits ◽

Neural Correlates ◽

Self Awareness

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Brain glucose metabolism changes in Parkinson's disease patients with CHCHD2 mutation based on 18 F-FDG PET imaging

Journal of the Neurological Sciences ◽

10.1016/j.jns.2016.08.042 ◽

2016 ◽

Vol 369 ◽

pp. 303-305 ◽

Cited By ~ 4

Author(s):

Cheng-yuan Mao ◽

Ping Wu ◽

Shu-yu Zhang ◽

Jing Yang ◽

Yu-tao Liu ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Glucose Metabolism ◽

Pet Imaging ◽

Fdg Pet ◽

Brain Glucose ◽

Brain Glucose Metabolism

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Lewy body densities in the entorhinal and anterior cingulate cortex predict cognitive deficits in Parkinson's disease

Acta Neuropathologica ◽

10.1007/s00401-003-0705-2 ◽

2003 ◽

Vol 106 (1) ◽

pp. 83-88 ◽

Cited By ~ 137

Author(s):

Enikö Kövari ◽

Gabriel Gold ◽

François R. Herrmann ◽

Alessandra Canuto ◽

Patrick R. Hof ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Anterior Cingulate Cortex ◽

Cognitive Deficits ◽

Lewy Body ◽

Cingulate Cortex ◽

Anterior Cingulate

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Role of the Cingulate Cortex in Dyskinesias-Reduced-Self-Awareness: An fMRI Study on Parkinson’s Disease Patients

Frontiers in Psychology ◽

10.3389/fpsyg.2018.01765 ◽

2018 ◽

Vol 9 ◽

Cited By ~ 12

Author(s):

Sara Palermo ◽

Leonardo Lopiano ◽

Rosalba Morese ◽

Maurizio Zibetti ◽

Alberto Romagnolo ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cingulate Cortex ◽

Self Awareness ◽

Fmri Study

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Cerebral glucose metabolism and cognitive impairment in tremor-dominant and akinetic-rigid subtypes of Parkinson’s disease

Neurology neuropsychiatry Psychosomatics ◽

10.14412/2074-2711-2020-6-42-48 ◽

2020 ◽

Vol 12 (6) ◽

pp. 42-48

Author(s):

I. V. Miliukhina ◽

Yu. G. Khomenko ◽

E. V. Gracheva ◽

G. V. Kataeva ◽

E. A. Gromova

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cognitive Impairment ◽

Glucose Metabolism ◽

Standard Procedure ◽

General Pattern ◽

Cingulate Cortex ◽

Cognitive Status ◽

Cerebral Glucose Metabolism ◽

Anterior Cingulate

Parkinson’s disease (PD) is a disease characterized by marked phenotypic heterogeneity. The akinetic-rigid (AR) and tremor-dominant (TD) types of PD differ not only in motor manifestations, but also in the severity of non-motor symptoms, including cognitive impairment (CI). It is the PD heterogeneity study that can achieve the task of creating a modern personalized therapy for this disease.Objective: to study the characteristics of cerebral glucose metabolism in CI in patients with AR and TD PD.Patients and methods. Examinations were made in 69 patients with PD (the TD and AR subtypes were in 23 and 46 patients, respectively). Their cognitive status was assessed using the Mini-mental State Examination, the Montreal Cognitive Assessment, the Frontal Assessment Battery, and the Clock Drawing Test. 18F-fluorodeoxyglucose positron emission tomography was performed according to the standard procedure; glucose metabolism rate (GMR) was determined in different Brodmann areas (BA).Results and discussion. GMR in the frontal areas (right BA 6, 8, 9, 46 and left BA 46) was lower in the AR group that in the TD one (p< 0.05). The severity of CI in the AR group correlated with GMR in the parietal and posterior cingulate cortex (BA 7, 23, 26, 29, 30, and 31). The TD group showed correlations of the values of cognitive tests mainly with GMR in the frontal and anterior cingulate cortex (BA 6, 8–11, 24), and in the parietal (BA 7) and temporal cortices (BA 22). The only area, in which GMR correlated with cognitive performance in both groups, was BA 7.Conclusion. Two distinct patterns of GMR were identified in AR and TD within the general pattern of decreased cerebral glucose metabolism, which was specific for CI in PD. The findings may suggest that there are two different CI pathogenetic mechanisms associated with the clinical subtypes of PD.

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