49 Loss of insight for cognitive symptoms in posterior cortical atrophy. (28th May 2019)

• Record Type: Journal Article
• Authors: Ahmed, S; Drummond, N; Butler, C
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 90(2019)Supplement 2
• Page Start: A23
• Page End: A23
• Publication Date: 2019-05-28
• Subjects: Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp-2019-BNPA.49
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : Objective: Lack of awareness or underestimation of cognitive deficits is a common feature in several neurodegenerative disorders, including Alzheimer's Disease (AD). Little is known about the profile of insight loss in atypical clinical variants of AD, such as posterior cortical atrophy (PCA). Insight loss is typically associated with negative outcomes for patients and their carers. Characterising the profile in PCA may therefore have important implications for management. Methods: Seventeen PCA patients and 21 healthy controls estimated their ability in five cognitive domains: visuospatial skills, visual imagery, attention, verbal memory and language, before undertaking objective neuropsychological testing in these domains. An index of insight was obtained by calculating a discrepancy score between estimated and objective memory scores. Results: A repeated measures ANOVA using group (healthy controls and PCA) and insight domain (visuospatial, visual imagery, attention, verbal memory and language) revealed a significant interaction of group by domain (p<0.001). PCA patients showed significantly less insight in all 5 domains compared to healthy controls ( p s<0.001). Comparing cognitive domains, PCA patients showed significantly less insight in visuospatial and visual imagery ability compared to all other domains ( p s<0.000). Conclusions: Loss of insight affects the core visuospatial deficits which define PCA more than other cognitive domains. The findings of this study are the first to investigate loss of insight in PCA.