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- Title
Assessment of Patient Self-awareness and Related Neural Correlates in Frontotemporal Dementia and Corticobasal Syndrome.
- Authors
Levy, Sarah; Gansler, David; Huey, Edward; Wassermann, Eric; Grafman, Jordan
- Abstract
Objective We compared two different methods of assessing self-awareness (clinician-rated vs. self- and caregiver report) in participants with neurodegenerative conditions. Additionally, we examined the contribution of memory dysfunction to assessment of self-awareness. Method Sixty-seven participants with various neurodegenerative disorders participated in this study. Data were collected on brain volume, neurocognitive function, demographic characteristics, and two measures of patient self-awareness, defined as (1) the discrepancy between patient and caregiver ratings of dysexecutive syndrome and (2) clinician-observed rating of patient insight. Penalized regression with best subset variable selection and 10-fold cross-validation was used to evaluate three neurocognitive frameworks: self-regulation, language, and perspective-taking, each predicting the results from the two methods of self-awareness measurement. Results The self-regulation framework was more robustly predictive for both the clinician rating and discrepancy method than language or perspective-taking. Frameworks in which the clinician rating was the criterion were more robust than those with the discrepancy method as criterion. When a measure of memory functioning was added to the framework, there was no appreciable improvement in the prediction of self-awareness. Conclusions A self-regulation neurocognitive framework, consisting of regions of interest and neuropsychological test scores, was more effective in understanding patient self-awareness than perspective-taking or language frameworks. Compared to the discrepancy method, a clinician rating of self-awareness was more robustly associated with relevant clinical variables of regional brain volume and neuropsychological performance, suggesting it may be a useful measure to aid clinical diagnosis.
- Subjects
FRONTOTEMPORAL dementia; SELF-consciousness (Awareness); NEURAL circuitry; PATIENT self-monitoring; STATISTICAL correlation; DIAGNOSIS
- Publication
Archives of Clinical Neuropsychology, 2018, Vol 33, Issue 5, p519
- ISSN
0887-6177
- Publication type
Article
- DOI
10.1093/arclin/acx105