摘要
Background: Anosognosia is a common manifestation of Al zheimers disease. T here is an association between impaired awareness and frontal executive cogniti ve deficits. Anosognosia is also correlated with decreased metabolism in the rig ht hemisphere, particularly in frontal lobe regions. Objective: To investigate p athological correlates of anosognosia in Alzhe imers disease. Design: 41 subj ects followed longitudinally in the University of Pittsburgh memory disorders cl inic and with necropsy verified Alzheimers disease were divided into two group s, based on previous clinical assessment: +Aware (n = 23) and Aware (n = 18). A subset analysis matching sub jects for dementia severity using mini mental state examination scores was also carried out (13 +Aware; 13 Aware). Histopat hological data from necropsy brain tissue consisted of senile plaque (SP) and ne urofibrillary tangle (NFT) counts (regional density) from four different brain r egions in the right and left hemispheres: superior and middle frontal gyri (SMF) , superior temporal isocortex (ST), the prosubiculum of the hippocampus (PRO), a nd the entorhinal cortex (EC). Results: SP density was greater in the right PRO region of Aware subjects (F = 6.54, p = 0.015) than +Aware subjects. Signific ant differences between SP or NFT density were not observed in any other regions . In the subset analysis matching for dementia severity, SP density was again gr eater in the right PRO region of Aware subjects than in the other regions (F = 12.72, p = 0.002). Conclusions: Increased SP density in the right PRO region suggests that selective pathological involvement of th is area contributes to awareness deficits in Alzheimers disease. The putative role of the PRO in self appraisal may reflect its interconnections with other me dial temporal and prefrontal regions.
Background: Anosognosia is a common manifestation of Al zheimers disease. T here is an association between impaired awareness and frontal executive cogniti ve deficits. Anosognosia is also correlated with decreased metabolism in the rig ht hemisphere, particularly in frontal lobe regions. Objective: To investigate p athological correlates of anosognosia in Alzhe imers disease. Design: 41 subj ects followed longitudinally in the University of Pittsburgh memory disorders cl inic and with necropsy verified Alzheimers disease were divided into two group s, based on previous clinical assessment: +Aware (n = 23) and Aware (n = 18). A subset analysis matching sub jects for dementia severity using mini mental state examination scores was also carried out (13 +Aware; 13 Aware). Histopat hological data from necropsy brain tissue consisted of senile plaque (SP) and ne urofibrillary tangle (NFT) counts (regional density) from four different brain r egions in the right and left hemispheres: superior and middle frontal gyri (SMF) , superior temporal isocortex (ST), the prosubiculum of the hippocampus (PRO), a nd the entorhinal cortex (EC). Results: SP density was greater in the right PRO region of Aware subjects (F = 6.54, p = 0.015) than +Aware subjects. Signific ant differences between SP or NFT density were not observed in any other regions . In the subset analysis matching for dementia severity, SP density was again gr eater in the right PRO region of Aware subjects than in the other regions (F = 12.72, p = 0.002). Conclusions: Increased SP density in the right PRO region suggests that selective pathological involvement of th is area contributes to awareness deficits in Alzheimers disease. The putative role of the PRO in self appraisal may reflect its interconnections with other me dial temporal and prefrontal regions.
出处
《世界核心医学期刊文摘（神经病学分册）》
2005年第2期31-32,共2页
Digest of the World Core Medical Journals:Clinical Neurology
