Reduced awareness of cognitive deficits in idiopathic normal pressure hydrocephalus and its change following lumbar puncture.

Autor: Löbig N; Department of Psychology, Humboldt-Universität zu Berlin, Germany; Clinic of Neurology, Hospital Ernst-von-Bergmann, Potsdam, Brandenburg, Germany. Electronic address: nicolas.loebig@hu-berlin.de., Pagenkopf C; Clinic of Neurology, Hospital Ernst-von-Bergmann, Potsdam, Brandenburg, Germany., Südmeyer M; Clinic of Neurology, Hospital Ernst-von-Bergmann, Potsdam, Brandenburg, Germany., Werheid K; Department of Psychology, Bielefeld University, Germany.
Jazyk: angličtina
Zdroj: Cortex; a journal devoted to the study of the nervous system and behavior [Cortex] 2024 Oct; Vol. 179, pp. 157-167. Date of Electronic Publication: 2024 Aug 14.
DOI: 10.1016/j.cortex.2024.07.010
Abstrakt: Objective: Awareness of cognitive deficits is related to executive functions and may, therefore, be sensitive to the effects of lumbar puncture (LP) in idiopathic normal pressure hydrocephalus (iNPH). Although a reduction in awareness of cognitive deficits (RACD) has been previously described in iNPH, there is a lack of systematic, psychometrically validated reports. In this study, we investigated RACD and its LP-related changes in iNPH patients and compared them with those in clinical and healthy control groups.
Methods: RACD was assessed before and after lumbar puncture (LP) in 24 patients (14 iNPH, 10 other age-associated cognitive syndromes; AACS) and compared with 23 healthy controls (HC), employing two RACD measures alongside cognitive examination. Local metacognition was measured using a visual percentile-based rating system and operationalized as the t-scaled distance between the participants' task-specific performance estimations and their objective test performance (ΔTSPE). Global metacognition, targeting broader estimates of cognitive functioning (ECF), was quantified by subtracting self- from informant-obtained sum scores on a questionnaire evaluating participants' dysexecutive problems (DEX-DS). Within-group and between-group differences in ΔTSPE and DEX-DS scores were compared non-parametrically, focusing on post-LP changes.
Results: Averaged ΔTSPE was higher in the patient groups and mirrored the groups' lower objective test performance, while averaged DEX-DS showed no group difference. Following LP, group comparisons revealed iNPH-specific decrease in both RACD measures.
Conclusion: Our study revealed LP-related RACD changes in iNPH patients compared to those in AACS and HC participants. The results suggest a mitigation of impaired metacognitive abilities in iNPH, possibly resulting from LP-induced improvements in (local) metacognitive performance, facilitating ECF adjustment alongside a metacognitively stimulating testing procedure.
(Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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