Ventromedial‐frontopolar prefrontal cortex atrophy correlates with insight loss in frontotemporal dementia and Alzheimer's disease |
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| Authors: | Michael Hornberger Belinda Yew Silvia Gilardoni Eneida Mioshi Ezequiel Gleichgerrcht Facundo Manes John R. Hodges |
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| Affiliation: | 1. Neuroscience Research Australia, Randwick, Sydney, Australia;2. Faculty of Medicine, University of New South Wales, Sydney, Australia;3. ARC Center of Excellence for Cognition and its Disorders, Sydney, Australia;4. Institute of Cognitive Neurology (INECO), Buenos Aires, Argentina;5. Laboratory of Neuroscience, Universidad Diego Portales, Santiago, Chile;6. Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina |
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| Abstract: | Loss in insight is a major feature of frontotemporal dementia (FTD) but has been investigated relatively little. More importantly, the neural basis of insight loss is still poorly understood. The current study investigated insight deficit profiles across a large cohort of neurodegenerative patients (n = 81), including FTD and Alzheimer's disease (AD) patients. We employed a novel insight questionnaire, which tapped into changes across different domains: social interaction, emotion, diagnosis/treatment, language, and motivation. FTD subtypes varied considerably for insight loss, with the behavioral variant worst and the progressive non‐fluent variant least affected. All other subtypes and AD showed milder but consistent insight loss. Voxel‐based morphometry analysis revealed that overall insight loss correlated with ventromedial and frontopolar prefrontal atrophy, with exception of social interaction and emotion insight loss, which additionally correlated with lateral temporal and amygdala atrophy, respectively. Our results show that patients with neurodegenerative conditions show variable loss of insight, with ventromedial and frontopolar cortex regions appearing to be particularly important for insight. Hum Brain Mapp 35:616–626, 2014. © 2012 Wiley Periodicals, Inc. |
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| Keywords: | frontotemporal dementia Alzheimer's disease insight self‐evaluation ventromedial frontal cortex frontopolar cortex voxel‐based morphometry |
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