Get access

Ventromedial-frontopolar prefrontal cortex atrophy correlates with insight loss in frontotemporal dementia and Alzheimer's disease

Authors

  • Michael Hornberger,

    Corresponding author
    1. Neuroscience Research Australia, Randwick, Sydney, Australia
    2. Faculty of Medicine, University of New South Wales, Sydney, Australia
    3. ARC Center of Excellence for Cognition and its Disorders, Sydney, Australia
    Search for more papers by this author
  • Belinda Yew,

    1. Neuroscience Research Australia, Randwick, Sydney, Australia
    Search for more papers by this author
  • Silvia Gilardoni,

    1. Neuroscience Research Australia, Randwick, Sydney, Australia
    Search for more papers by this author
  • Eneida Mioshi,

    1. Neuroscience Research Australia, Randwick, Sydney, Australia
    2. Faculty of Medicine, University of New South Wales, Sydney, Australia
    Search for more papers by this author
  • Ezequiel Gleichgerrcht,

    1. Institute of Cognitive Neurology (INECO), Buenos Aires, Argentina
    2. Laboratory of Neuroscience, Universidad Diego Portales, Santiago, Chile
    3. Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina
    Search for more papers by this author
  • Facundo Manes,

    1. Institute of Cognitive Neurology (INECO), Buenos Aires, Argentina
    2. Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina
    Search for more papers by this author
  • John R. Hodges

    1. Neuroscience Research Australia, Randwick, Sydney, Australia
    2. Faculty of Medicine, University of New South Wales, Sydney, Australia
    3. ARC Center of Excellence for Cognition and its Disorders, Sydney, Australia
    Search for more papers by this author

Abstract

Loss in insight is a major feature of frontotemporal dementia (FTD) but has been investigated relatively little. More importantly, the neural basis of insight loss is still poorly understood. The current study investigated insight deficit profiles across a large cohort of neurodegenerative patients (n = 81), including FTD and Alzheimer's disease (AD) patients. We employed a novel insight questionnaire, which tapped into changes across different domains: social interaction, emotion, diagnosis/treatment, language, and motivation. FTD subtypes varied considerably for insight loss, with the behavioral variant worst and the progressive non-fluent variant least affected. All other subtypes and AD showed milder but consistent insight loss. Voxel-based morphometry analysis revealed that overall insight loss correlated with ventromedial and frontopolar prefrontal atrophy, with exception of social interaction and emotion insight loss, which additionally correlated with lateral temporal and amygdala atrophy, respectively. Our results show that patients with neurodegenerative conditions show variable loss of insight, with ventromedial and frontopolar cortex regions appearing to be particularly important for insight. Hum Brain Mapp 35:616–626, 2014. © 2012 Wiley Periodicals, Inc.

Get access to the full text of this article

Ancillary