RELATION OF ANOSOGNOSIA TO FRONTAL-LOBE DYSFUNCTION IN ALZHEIMERS-DISEASE

A self-rating scale of memory functions was administered to 24 non-dep ressed patients with probable Alzheimer's disease, divided into two gr oups according to the overall severity of dementia (mild, mini-mental state (MMS) >21; moderate, MMS between 10 and 20). These groups did no t significantly differ in their self-rating of memory functions. The s ame questionnaire was submitted to a member of each patient's family, who had to rate the patient's memory. An ''(anosognosia score'' was de fined as the difference between patient's and family's ratings. This s core was highly variable, and covered, in the two groups, the full ran ge between complete awareness of deficits and total anosognosia. Corre lations between the anosognosia score and several neuropsychological d ata were searched for. No significant correlation was found with eithe r the Wechsler memory scale, the MMS, or linguistic abilities and gest ures. In contrast, this score was highly correlated with the (''fronta l score'', defined as the sum of scores on the Wisconsin card sorting test (WCST), verbal fluency, Luria's graphic series, and ''frontal beh aviours'' (prehension, utilisation, imitation behaviours, inertia, ind ifference). Among these tests of executive functions, the highest corr elation with the anosognosia score was obtained on the WCST. This sugg ests that anosognosia in Alzheimer's disease is not related to the deg ree of cognitive deterioration but results, at least in part, from fro ntal dysfunction.