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See detailA Comparison of Unawareness in Frontotemporal Dementia and Alzheimer's Disease
Salmon, Eric ULg; Perani, Daniela; Collette, Fabienne ULg et al

in Journal of Neurology, Neurosurgery & Psychiatry (2008), 79(2), 176-9

BACKGROUND: Loss of insight is a core diagnostic feature of frontotemporal dementia (FTD) and anosognosia is frequently reported in Alzheimer's disease (AD). AIM: To compare unawareness (anosognosia) for ... [more ▼]

BACKGROUND: Loss of insight is a core diagnostic feature of frontotemporal dementia (FTD) and anosognosia is frequently reported in Alzheimer's disease (AD). AIM: To compare unawareness (anosognosia) for different symptoms, measured with a discrepancy score between patient's and caregiver's assessment, in AD and FTD. METHOD: In a prospective, multi-centre study, 123 patients with probable AD, selected according to the NINCDS-ADRDA procedure, were matched for age, sex, education, disease duration and dementia severity to patients with FTD (n = 41), selected according to international consensus criteria. A research complaint questionnaire was used to obtained patient's and caregiver's assessment concerning neuropsychological and behavioural symptoms. Data were compared in each group and between groups. Unawareness (measured by discrepancy scores) was compared between patients with AD and FTD. RESULTS: The caregivers generally assessed symptoms more severely than did patients, but both patient groups reported changes in affect (depressive mood or irritability) as their caregivers did. Unawareness was greater in patients with FTD than in patients with AD for language and executive difficulties, and for changes in behaviour and daily activities. CONCLUSION: The main finding is that unawareness was observed in both patients with FTD and patients with AD for most clinical domains. However, qualitative and quantitative differences showed that lack of awareness was greater in patients with FTD. [less ▲]

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See detailTwo Aspects of Impaired Consciousness in Alzheimer's Disease
Salmon, Eric ULg; Ruby, Perrine; Perani, Daniela et al

in Progress in Brain Research (2005), 150(Boundaries of Consciousness: Neurobiology and Neuropathology), 287-98

Alzheimer's disease (AD) is a degenerative dementia characterized by different aspects of impaired consciousness. For example, there is a deficit of controlled processes that require conscious processing ... [more ▼]

Alzheimer's disease (AD) is a degenerative dementia characterized by different aspects of impaired consciousness. For example, there is a deficit of controlled processes that require conscious processing of information. Such an impairment is indexed by decreased performances at controlled cognitive tasks, and it is related to reduced brain metabolic activity in a network of frontal, posterior associative, and limbic regions. Another aspect of impaired consciousness is that AD patients show variable levels of anosognosia concerning their cognitive deficits. A discrepancy score between patient's and caregiver's assessment of cognitive functions is one of the most frequently used measures of anosognosia. A high discrepancy score has been related to impaired activity in the superior frontal sulcus and the parietal cortex in AD. Anosognosia for cognitive deficits in AD could be partly explained by impaired metabolism in parts of networks subserving self-referential processes (e.g., the superior frontal sulcus) and perspective-taking (e.g., the temporoparietal junction). We hypothesize that these patients are impaired in the ability to see themselves with a third-person perspective (i.e., being able to see themselves as other people see them). [less ▲]

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See detailPredominant ventromedial frontopolar metabolic impairment in frontotemporal dementia
Salmon, Eric ULg; Garraux, Gaëtan ULg; Delbeuck, Xavier et al

in NeuroImage (2003), 20(1), 435-440

In a multicenter study, FDG-PET images in a population of 29 patients with frontotemporal dementia (FTD) were compared to controls with similar age from each center. A conjunction analysis led to ... [more ▼]

In a multicenter study, FDG-PET images in a population of 29 patients with frontotemporal dementia (FTD) were compared to controls with similar age from each center. A conjunction analysis led to identification of the ventromedial frontopolar cortex as the single region affected in each and every FTD patients. This precise regional metabolic impairment should be integrated with recent neuropsychological researches, such as those showing that the ventromedial frontal cortex is critically involved in decision-making processes based on personal experience, feelings of rightness or social knowledge, processes that are characteristically impaired in FTD. (C) 2003 Elsevier Inc. All rights reserved. [less ▲]

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