You will find here a brief presentation on the following paper:
Neural correlates of altered insight in frontotemporal dementia: a systematic review (Munoz-Neira et al., 2019), NeuroImage: Clinical 24 (2019) 102066
Move forward (or backwards) as you wish…
Problematization
Altered insight is a prominent symptom of frontotemporal dementia.
There has been a considerable variability in the methods used to explore the neural correlates of altered insight in dementia and other brain disorders.
Problematization
Different insight assessment methods and brain imaging techniques used to further study altered insight.
Diverse methodology
Problematization
Have authors been studying the same clinical phenomenon?
Altered insight ~ Anosognosia ~ Unawareness?
Potential solution
Fractionating altered insight into different objects (broad versus specific objects).
Broad and specific objects of insight
Objective
Provide an answer to the following question: are broad and specific objects of insight underpinned by different or compatible brain areas in frontotemporal dementia?
Methods
6 databases were explored: MEDLINE, Embase, PsycInfo, Web of Science, BIOSIS and ProQuest Dissertations & Theses Global.
The focus was on publications that explored any aspect of altered insight in FTD or its associated syndromes through any brain imaging method.
Studies conducted in humans, published in English between 1980 and August 2019 were included.
Methods
Medline Screenshot
Results
15 papers out of 660 articles finally met the selection criteria.
Most of the studies (~50%) explored global insight loss or altered insight into social cognition.
Results
Findings (1)
Results
Structural studies associated global altered insight with atrophies in orbitofrontal cortex, ventromedial prefrontal cortex and frontopolar areas in bvFTD and language variants of FTD, whereas functional studies tended to associate global insight loss with frontal right dysfunction in bvFTD.
Results
Altered insight into social cognition was mainly explored with structural brain imaging studies in FTD and the results suggest correlations with involvement of orbitofrontal cortex and areas placed throughout the limbic system.
Other domains of insight showed associations with diverse brain areas.
Results
Findings (2)
Discussion
Broad and specific objects of insight seem to be underpinned by different neural correlates in FTD.
Are those results conditioned by the insight assessment methods and brain imaging techniques?
Discussion
Future work should triangulate different insight assessment approaches and brain imaging techniques to increase the understanding of this highly relevant clinical phenomenon in dementia.
Questions?
Please, click here to find out more about this paper!
Also, do not hesitate to email me (carlos.munoz@sheffield.ac.uk) in case you would like to discuss further any issue about this publication…
