title: Frontal lobe hypometabolism and impaired insight in Alzheimer disease.
abstract: 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.
authors.affiliation: Neuropsychiatric Institute and Hospital, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, Univ. of California, Los Angeles, CA, USA.
authors.forename: Dylan G
authors.initials: DG
authors.lastname: Harwood
authors.forename: David L
authors.initials: DL
authors.lastname: Sultzer
authors.forename: Denise
authors.initials: D
authors.lastname: Feil
authors.forename: Lorena
authors.initials: L
authors.lastname: Monserratt
authors.forename: Evan
authors.initials: E
authors.lastname: Freedman
authors.forename: Mark A
authors.initials: MA
authors.lastname: Mandelkern
mesh_terms: 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
chemical_list: D001786:Blood Glucose; D019788:Fluorodeoxyglucose F18