Maria Donata Orfei1, Francesca Assogna2, Clelia Pellicano3, Francesco Ernesto Pontieri4, Carlo Caltagirone5, Mariangela Pierantozzi6, Alessandro Stefani7, Gianfranco Spalletta8. 1. Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, Rome, Italy. Electronic address: md.orfei@hsantalucia.it. 2. Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, Rome, Italy; Centro Fermi - Museo Storico della Fisica e Centro Studi e Ricerche "Enrico Fermi", Rome, Italy. Electronic address: f.assogna@hsantalucia.it. 3. Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, Rome, Italy; Dipartimento di Neuroscienze, Salute Mentale e Organi di Senso (NESMOS), Sapienza Università di Roma, Via di Grottarossa, 1035, 00189, Roma, Italy. Electronic address: pellicanoc@gmail.com. 4. Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, Rome, Italy; Dipartimento di Neuroscienze, Salute Mentale e Organi di Senso (NESMOS), Sapienza Università di Roma, Via di Grottarossa, 1035, 00189, Roma, Italy. Electronic address: fe.pontieri@gmail.com. 5. Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, Rome, Italy; Neuroscience Department, Tor Vergata University, Rome, Italy. Electronic address: c.caltagirone@hsantalucia.it. 6. Department of Medicine of Systems, University "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy. Electronic address: pierantozzim@gmail.com. 7. Department of Medicine of Systems, University "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy. Electronic address: stefani@uniroma2.it. 8. Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, Rome, Italy; Division of Neuropsychiatry, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Tx, USA. Electronic address: g.spalletta@hsantalucia.it.
Abstract
INTRODUCTION: Anosognosia is a multidimensional phenomenon with detrimental effects on patients' illness course, therapy compliance and quality of life. We aimed at investigating anosognosia for cognitive and behavioral symptoms in Parkinson's Disease (PD) with dementia (PDD) and, for the first time, in PD with Mild Cognitive Impairment (MCI-PD). METHODS: Community dwelling subjects (47 mild PDD, 136 multidomain MCI-PD (mdMCI-PD), 5 single domain MCI-PD (sdMCI-PD), and 197 PD without cognitive impairment (noCI-PD) were enrolled in a cross-sectional design study. All the subjects were administered the Anosognosia Questionnaire for Dementia, the Mental Deterioration Battery and a number of neuropsychiatric inventories. RESULTS: A diagnosis of anosognosia was made in 36% of patients with mild PDD and 16% with mdMCI-PD, whether it was negligible in sdMCI-PD and noCI-PD. Higher severity of anosognosia for cognitive impairment was also found in PDD and in mdMCI-PD. SdMCI-PD had the lower severity of anosognosia for cognitive impairment. Higher anosognosia for cognitive impairment was associated to lower depression in noCI-PD (r = -0.227, p = 0.0013) and mdMCI-PD (r = -0.266, p = 0.0016), and to reduced hedonic tone in noCI-PD (r = -0.191, p = 0.0071). Greater anosognosia was associated to lower executive performances in PDD (r = 0.424, p = 0.0074). CONCLUSIONS: Anosognosia for non-motor symptoms is frequent in PD patients with mild dementia or mdMCI. Results confirm the role of neuropsychiatric characteristics in anosognosia also in PD, the high prevalence of anosognosia in neurodegenerative illnesses and suggest a common pathogenic path for anosognosia in different neurodegenerative and psychiatric disorders.
INTRODUCTION: Anosognosia is a multidimensional phenomenon with detrimental effects on patients' illness course, therapy compliance and quality of life. We aimed at investigating anosognosia for cognitive and behavioral symptoms in Parkinson's Disease (PD) with dementia (PDD) and, for the first time, in PD with Mild Cognitive Impairment (MCI-PD). METHODS: Community dwelling subjects (47 mild PDD, 136 multidomain MCI-PD (mdMCI-PD), 5 single domain MCI-PD (sdMCI-PD), and 197 PD without cognitive impairment (noCI-PD) were enrolled in a cross-sectional design study. All the subjects were administered the Anosognosia Questionnaire for Dementia, the Mental Deterioration Battery and a number of neuropsychiatric inventories. RESULTS: A diagnosis of anosognosia was made in 36% of patients with mild PDD and 16% with mdMCI-PD, whether it was negligible in sdMCI-PD and noCI-PD. Higher severity of anosognosia for cognitive impairment was also found in PDD and in mdMCI-PD. SdMCI-PD had the lower severity of anosognosia for cognitive impairment. Higher anosognosia for cognitive impairment was associated to lower depression in noCI-PD (r = -0.227, p = 0.0013) and mdMCI-PD (r = -0.266, p = 0.0016), and to reduced hedonic tone in noCI-PD (r = -0.191, p = 0.0071). Greater anosognosia was associated to lower executive performances in PDD (r = 0.424, p = 0.0074). CONCLUSIONS: Anosognosia for non-motor symptoms is frequent in PDpatients with mild dementia or mdMCI. Results confirm the role of neuropsychiatric characteristics in anosognosia also in PD, the high prevalence of anosognosia in neurodegenerative illnesses and suggest a common pathogenic path for anosognosia in different neurodegenerative and psychiatric disorders.
Authors: Matthias Löhle; Alexander Bremer; Florin Gandor; Jonathan Timpka; Per Odin; Georg Ebersbach; Alexander Storch Journal: NPJ Parkinsons Dis Date: 2022-06-02
Authors: Brenna Cholerton; Kathleen L Poston; Lu Tian; Joseph F Quinn; Kathryn A Chung; Amie L Hiller; Shu-Ching Hu; Krista Specketer; Thomas J Montine; Karen L Edwards; Cyrus P Zabetian Journal: Mov Disord Clin Pract Date: 2019-12-14