Affiliations: [a] Department of Neurology, AHEPA University Hospital, Thessaloniki, Greece | [b] Laboratory of Nuclear Medicine, Asclepius Diagnostic Center, Thessaloniki, Greece | [c] Laboratory of Nuclear Medicine, AHEPA University Hospital, Thessaloniki, Greece | [d] Department of Radiology, AHEPA University Hospital, Thessaloniki, Greece
Abstract: Anosognosia is a common symptom of dementia. The aim of this study was to evaluate the contribution of different regions of the brain to anosognosia in Alzheimer's disease (AD) brains using single photon emission computed tomography (SPECT). Forty-two patients with AD were included in this study. After clinical interviews with the patients and their relatives, the patients were divided into two groups: Anosognosia and No-anosognosia. The patients were studied regarding the severity of dementia. They underwent SPECT with HMPAO and regional cerebral blood flow (rCBF) was measured. Regional CBF significantly differed between Anosognosia and No-anosognosia groups in right prefrontal (P ⩽ 0.02), right inferior parietal (P ⩽ 0.00), and right (P ⩽ 0.01) and left (P ⩽ 0.01) medial temporal cortex. There was a significant correlation between the severity of dementia and rCBF in medial temporal regions. When comparisons were made between mild and moderate stages separately, the 'right inferior parietal region' was the common region which showed hypoperfusion in both anosognosia subgroups. We conclude that anosognosia may be a reflection of functional impairment in right prefrontal, right frontal and especially right inferior parietal regions in AD.
Keywords: Alzheimer, anosognosia, brain SPECT, disease unawareness, right parietal, right prefrontal
