Abstract
Awareness of deficits in patients with neurological disorders may be described as a theoretical unitary phenomenon, which has been analysed reaching interesting results in the last decades. Awareness of deficits manifests itself in a continuum ranging from full awareness to total absence. In line with a neurocognitive approach, a reduction in self-awareness could be explained considering executive dysfunction associated with prefrontal cortex anatomo-functional changes. Our mini-review will focus on reduced self-awareness in neurological disorders, such as Alzheimer’s disease, behavioural Frontotemporal Dementia and Acquired Brain Injuries. Results achieved thanks to an explanatory investigative approach combined with a theoretical reference model will be presented. Data suggest the key role of executive functions in supporting adequate self-awareness towards patients’ cognitive-behavioural profile and instrumental activity autonomy. The Cognitive Awareness Model seems to be one of the best theoretical model to better approach this phenomenon.
Highlights
Awareness of deficits appears in a continuum ranging from full awareness to total absence
A relationship between DRSA and an hypoactivity of the bilateral anterior cingulate cortex (ACC), bilateral anterior insular cortex and right dorsolateral prefrontal cortex had been showed (Palermo et al, 2018). These results indicate how the executive deficits impact on reduced self-awareness in neurodegenerative disorders, and how the ACC is the main hub of the damaged response-inhibition circuit
Metacognitive executive dysfunction and medial prefrontal cortex (MPFC) impairment, delineated through the neurocognitive model, may help to understand how the central executive system could contribute to self-awareness disorders related to Alzheimer’s disease (AD), behavioural Frontotemporal Dementia (bvFTD) and Acquired Brain Injury (ABI) (Starkstein et al, 1995; Litvan et al, 1996, 1997; Agnew and Morris, 1998; Amanzio et al, 2011, 2013, 2016; Palermo et al, 2014)
Summary
Awareness of deficits appears in a continuum ranging from full awareness to total absence. The Cognitive Awareness Model (CAM) (Agnew and Morris, 1998; Mograbi and Morris, 2014), originally developed to explain awareness deficits in AD, may be applied in both neurodegenerative disorders (O’Keeffe et al, 2007) and ABI patients (Sherer et al, 1998; Prigatano, 1999; Ownsworth et al, 2002) This model is characterised by a comparator system in the central executive system, which controls mismatches between a personal database and consciousness of failure in cognitive or in behavioural performances (Agnew and Morris, 1998; FIGURE 1 | A graphical representation of the model proposed by Stuss et al (2001) and Stuss and Anderson (2004). It had been proposed that the central executive system (Baddeley, 1986) accounts for a reduction of awareness in AD (Lopez et al, 1994), in particular when it is severely impaired
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
