Chavoix Chantal, Insausti Ricardo
Normandie Univ. UNICAEN, INSERM, COMETE, PFRS, 14000 Caen, France.
Human Neuroanatomy Laboratory, School of Medicine and CRIB, University of Castilla-La Mancha, Almansa 14, 02006, Albacete, Spain.
Neurosci Biobehav Rev. 2017 Jul;78:1-12. doi: 10.1016/j.neubiorev.2017.04.015. Epub 2017 Apr 19.
Accurate self-awareness is essential for adapting one's behaviour to one's actual abilities, to avoid risky behaviour. Impaired self-awareness of deficits is common in neurodegenerative diseases. Numerous studies show an involvement of midline cortical areas in impaired self-awareness. Among the other brain regions implicated stand the medial temporal lobe (MTL) structures (i.e. hippocampus, amygdala, and temporopolar, entorhinal, perirhinal and posterior parahippocampal cortices). This review aims at evaluating the role of those structures in self-awareness in neurodegenerative diseases. To this aim, we briefly review impaired self-awareness in neurodegenerative diseases, give a neuroanatomical background on the MTL structures, and report those identified in neuroimaging studies on self-awareness. The MTL shows neuropathological, and structural or functional changes in patients who overestimate their abilities in the cognitive, socio-emotional or daily life activities domains. The structures implicated differ depending on the domain considered, suggesting a modality-specific involvement. The functional significance of the findings is discussed in view of the neuroanatomical networks of the MTL and in the context of theoretical models of self-awareness.
准确的自我认知对于使个人行为适应自身实际能力、避免危险行为至关重要。对缺陷的自我认知受损在神经退行性疾病中很常见。大量研究表明，中线皮质区域与自我认知受损有关。其他涉及的脑区包括内侧颞叶（MTL）结构（即海马体、杏仁核以及颞极、内嗅皮质、嗅周皮质和海马旁后皮质）。本综述旨在评估这些结构在神经退行性疾病自我认知中的作用。为此，我们简要回顾神经退行性疾病中的自我认知受损情况，介绍MTL结构的神经解剖学背景，并报告神经影像学研究中确定的与自我认知相关的情况。MTL在认知、社会情感或日常生活活动领域高估自身能力的患者中显示出神经病理学以及结构或功能变化。所涉及的结构因所考虑的领域而异，表明存在特定模式的参与。鉴于MTL的神经解剖网络以及自我认知的理论模型，对这些发现的功能意义进行了讨论。
