Frontal lobe hypometabolism and impaired insight in Alzheimer disease.
OBJECTIVE
The authors examined the relationship between impaired insight regarding cognitive and functional deficits and frontal cortex hypometabolism in 41 patients with Alzheimer disease (AD).


METHODS
Regional cerebral glucose metabolism was determined with (18F)fluorodeoxyglucose and positron emission tomography. Level of insight was measured with the clinician-rated Neurobehavioral Rating Scale, and severity of global cognitive impairment was determined with the Mini-Mental State Exam.


RESULTS
Inaccurate insight was correlated with glucose metabolic rate in the right lateral frontal cortex (Brodmann areas 6 and 45, and the lateral aspect of Brodmann areas 8 and 9) after controlling for global cognitive dysfunction.


CONCLUSIONS
The findings from this study help to further elucidate the neurobiological mechanisms underlying impaired insight in AD, indicating a link between this important clinical phenomenon and dysmetabolism in a focal region of the right prefrontal cortex.
Harwood
Dylan G
DG
Neuropsychiatric Institute and Hospital, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, Univ. of California, Los Angeles, CA, USA.
Sultzer
David L
DL
Feil
Denise
D
Monserratt
Lorena
L
Freedman
Evan
E
Mandelkern
Mark A
MA
D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D001364:Awareness / Q000502:physiology*; D001786:Blood Glucose / Q000378:metabolism; D003072:Cognition Disorders / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D004292:Dominance, Cerebral / Q000502:physiology; D004734:Energy Metabolism / Q000502:physiology*; D005260:Female; D019788:Fluorodeoxyglucose F18; D005625:Frontal Lobe / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D009483:Neuropsychological Tests; D049268:Positron-Emission Tomography; D011594:Psychometrics; D013223:Statistics as Topic
D001786:Blood Glucose; D019788:Fluorodeoxyglucose F18