49 Loss of insight for cognitive symptoms in posterior cortical atrophy

S. Ahmed, N. Drummond, C. Butler
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Abstract

Objective Lack of awareness or underestimation of cognitive deficits is a common feature in several neurodegenerative disorders, including Alzheimer’s Disease (AD). Little is known about the profile of insight loss in atypical clinical variants of AD, such as posterior cortical atrophy (PCA). Insight loss is typically associated with negative outcomes for patients and their carers. Characterising the profile in PCA may therefore have important implications for management. Methods Seventeen PCA patients and 21 healthy controls estimated their ability in five cognitive domains: visuospatial skills, visual imagery, attention, verbal memory and language, before undertaking objective neuropsychological testing in these domains. An index of insight was obtained by calculating a discrepancy score between estimated and objective memory scores. Results A repeated measures ANOVA using group (healthy controls and PCA) and insight domain (visuospatial, visual imagery, attention, verbal memory and language) revealed a significant interaction of group by domain (p Conclusions Loss of insight affects the core visuospatial deficits which define PCA more than other cognitive domains. The findings of this study are the first to investigate loss of insight in PCA.
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后皮质萎缩中认知症状的洞察力丧失
缺乏对认知缺陷的认识或低估是包括阿尔茨海默病(AD)在内的几种神经退行性疾病的共同特征。对于AD的非典型临床变异(如后皮质萎缩(PCA))中洞察力丧失的特征知之甚少。洞察力丧失通常与患者及其护理人员的负面结果有关。因此,在PCA中描述概要可能对管理具有重要意义。方法17例PCA患者和21例健康对照者在进行视觉空间技能、视觉意象、注意力、言语记忆和语言等5个认知领域的客观神经心理测试前,对其能力进行评估。通过计算估计和客观记忆分数之间的差异得分,获得洞察力指数。结果使用组(健康对照和PCA)和洞察力领域(视觉空间、视觉意象、注意、言语记忆和语言)进行的重复测量方差分析显示,组与领域之间存在显著的相互作用(p)。结论洞察力丧失对定义PCA的核心视觉空间缺陷的影响大于其他认知领域。本研究的发现是第一个调查洞察力丧失在PCA。
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