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Anosognosia in Alzheimer disease: Disconnection between memory and self-related brain networks
Perrotin A, Desgranges B, Landeau B, Mézenge F, La Joie R, Egret S, Pélerin A, de la Sayette V et al.. Annals of neurology, 2015-07-21
Topic: Amyloid, tau and blood-test diagnosis
Objective Impaired awareness is a common symptom in many mental disorders including Alzheimer disease (AD). This study aims at improving our understanding of the neural mechanisms underlying anosognosia of memory deficits in AD by combining measures of regional brain metabolism (resting state fluorodeoxyglucose positron emission tomography [FDG-PET]) and intrinsic connectivity (resting state functional magnetic resonance imaging [fMRI]). Methods Twenty-three patients diagnosed with probable AD based on clinical and biomarker data and 30 matched healthy control subjects were recruited in this study. An anosognosia index (difference between subjective and objective memory scores) was obtained in each participant. Resting state FDG-PET for glucose metabolism measurement and resting state fMRI for intrinsic connectivity measurement were also performed. AD and control groups were compared on behavioral data, and voxelwise correlations between anosognosia and neuroimaging data were conducted within the AD group. Results AD patients underestimated their memory deficits. Anosognosia in AD patients correlated with hypometabolism in orbitofrontal (OFC) and posterior cingulate (PCC) cortices. Using OFC and PCC as seed regions, intrinsic connectivity analyses in AD revealed a significant association between anosognosia and reduced intrinsic connectivity between these regions as well as with the medial temporal lobe. Interpretation Anosognosia in AD is due not only to functional changes within cortical midline structures involved in self-referential processes (OFC, PCC), but also to disconnection between these regions as well as with the medial temporal lobe. These findings suggest that the lack of awareness of memory deficits in AD results from a disruption of the communication within, but also between, the self-related and the memory-related brain networks.
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APA 7th
Perrotin, A., Desgranges, B., Landeau, B., Mézenge, F., La Joie, R., Egret, S., et al. (2015). Anosognosia in Alzheimer disease: Disconnection between memory and self-related brain networks. Annals of neurology. https://doi.org/10.1002/ana.24462
Vancouver
Perrotin A, Desgranges B, Landeau B, Mézenge F, La Joie R, Egret S, et al. Anosognosia in Alzheimer disease: Disconnection between memory and self-related brain networks. Annals of neurology. 2015. doi:10.1002/ana.24462. PMID: 26085009.
BibTeX
@article{perrotin2015-26085009,
author = {Perrotin, A. and Desgranges, B. and Landeau, B. and Mézenge, F. and La Joie, R. and Egret, S. and Pélerin, A. and de la Sayette, V. and others},
title = {{Anosognosia in Alzheimer disease: Disconnection between memory and self-related brain networks}},
journal = {Annals of neurology},
year = {2015},
doi = {10.1002/ana.24462},
pmid = {26085009},
url = {https://doi.org/10.1002/ana.24462}
}
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Key findings
- Results AD patients underestimated their memory deficits.
- Using OFC and PCC as seed regions, intrinsic connectivity analyses in AD revealed a significant association between anosognosia and reduced intrinsic connectivity between these regions as well as with the medial temporal lobe.
- These findings suggest that the lack of awareness of memory deficits in AD results from a disruption of the communication within, but also between, the self-related and the memory-related brain networks.
Why it matters
In 23 patients with probable Alzheimer's disease, unawareness of memory deficits was associated with reduced metabolism in the orbitofrontal and posterior cingulate cortices and reduced connectivity between these regions and the medial temporal lobe. The findings suggest a disruption of communication between self-related and memory-related brain networks, but they do not test any treatment, cure or prevention.
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Study details
- Evidence strengthLow
How this study scored 47/100
Published in a leading specialty journal. Scored zero for study design, sample size, effect reported, studied in people and randomized / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Annals of neurology) |
| Journal's citation record | 3 / 4 | Annals of Neurology: journal h-index 437 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2015 — within 20 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 116 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 8.9 citations a year over 13 year(s) since 2015 |
| Impact for its field and year | 4 / 6 | Cited 10.2× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 2 / 4 | Cited 20 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Gaël Chételat: h-index 90 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Inserm: institution h-index 1,988 (OpenAlex) |
| Multicenter collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 26085009) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 47 / 100 | — |
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