title: Perspective taking to assess self-personality: what's modified in Alzheimer's disease?
abstract: Personality changes are frequently described by caregivers of patients with Alzheimer's disease, while they are less often reported by the patients. This relative anosognosia of Alzheimer disease (AD) patients for personality changes might be related to impaired self-judgment and to decreased ability to understand their caregiver's perspective. To investigate this issue, we explored the cerebral correlates of self-assessment and perspective taking in patients with mild AD, elderly and young volunteers. All subjects assessed relevance of personality traits adjectives for self and a relative, taking either their own or their relative's perspective, during a functional imaging experiment. The comparison of subject's and relative's answers provided congruency scores used to assess self-judgment and perspective taking performance. The self-judgment "accuracy" score was diminished in AD, and when patients assessed adjectives for self-relevance, they predominantly activated bilateral intraparietal sulci (IPS). Previous studies associated IPS activation with familiarity judgment, which AD patients would use more than recollection when retrieving information to assess self-personality. When taking a third-person perspective, patients activated prefrontal regions (similarly to young volunteers), while elderly controls recruited visual associative areas (also activated by young volunteers). This suggests that mild AD patients relied more on reasoning processes than on visual imagery of autobiographical memories to take their relative's perspective. This strategy may help AD patients to cope with episodic memory impairment even if it does not prevent them from making some mind-reading errors.
authors.affiliation: INSERM, U821, 69675 BRON Cedex, France. pruby@lyon.inserm.fr
authors.forename: Perrine
authors.initials: P
authors.lastname: Ruby
authors.forename: Fabienne
authors.initials: F
authors.lastname: Collette
authors.forename: Arnaud
authors.initials: A
authors.lastname: D'Argembeau
authors.forename: Frédéric
authors.initials: F
authors.lastname: Péters
authors.forename: Christian
authors.initials: C
authors.lastname: Degueldre
authors.forename: Evelyne
authors.initials: E
authors.lastname: Balteau
authors.forename: André
authors.initials: A
authors.lastname: Luxen
authors.forename: Pierre
authors.initials: P
authors.lastname: Maquet
authors.forename: Eric
authors.initials: E
authors.lastname: Salmon
mesh_terms: D000368:Aged; D000375:Aging; D000544:Alzheimer Disease / Q000503:physiopathology* / Q000523:psychology*; D001921:Brain / Q000503:physiopathology*; D001931:Brain Mapping; D005260:Female; D006801:Humans; D007600:Judgment / Q000502:physiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D010551:Personality / Q000502:physiology*; D010556:Personality Tests; D012647:Self-Assessment; D055815:Young Adult