Bălăeţ Maria, Alhajraf Falah, Bourke Niall J, Welch Jessica, Razzaque Jamil, Malhotra Paresh, Hu Michele T, Hampshire Adam
Department of Brain Sciences, Imperial College London, London, United Kingdom.
Oxford Parkinson's Disease Centre, Nuffield Department Clinical Neurosciences, University of Oxford, Oxford, United Kingdom.
Front Neurol. 2024 May 27;15:1399313. doi: 10.3389/fneur.2024.1399313. eCollection 2024.
Metacognition is the ability to monitor and self-assess cognitive performance. It can be impaired in neurodegenerative diseases, with implications for daily function, and the ability of patients to reliably report their symptoms to health professionals. However, metacognition has not been systematically assessed in early-mid stage Parkinson's disease (PD) and REM sleep behavioral disorder (RBD), a prodrome of PD.
This study aimed to evaluate metacognitive accuracy and self-confidence in PD and RBD patients across various cognitive tasks.
We conducted detailed computerized cognitive assessments with 19 cognitive tasks within an established PD and RBD cohort. Participants self-rated their performance post-task. Metacognitive accuracy was calculated by comparing these ratings against objective performance and further analyzed against clinical and mental health factors.
PD and RBD patients' metacognitive accuracy aligned with control subjects. However, they exhibited lower confidence across cognitive domains, reflecting their reduced cognitive performance. A notable inverse correlation was observed between their confidence and MDS-UPDRS I and II scales and HADS anxiety and depression scores.
Our findings indicate that patients with early to mid-stage PD and RBD are generally aware of their cognitive status, differing from other neurological disorders. The inverse relationship between patient confidence and symptoms of depression, anxiety, and daily life challenges underscores the impact of emotional and functional difficulties on their self-perception of cognitive abilities. This insight could be significant for understanding how these conditions affect mental health, aiding clinicians in developing more effective patient care strategies.
元认知是监测和自我评估认知表现的能力。它在神经退行性疾病中可能受损，这对日常功能以及患者向健康专业人员可靠报告其症状的能力都有影响。然而，元认知在帕金森病（PD）早期至中期以及PD前驱症状快速眼动睡眠行为障碍（RBD）中尚未得到系统评估。
本研究旨在评估PD和RBD患者在各种认知任务中的元认知准确性和自信心。
我们在一个既定的PD和RBD队列中，通过19项认知任务进行了详细的计算机化认知评估。参与者在任务完成后对自己的表现进行自我评分。通过将这些评分与客观表现进行比较来计算元认知准确性，并进一步针对临床和心理健康因素进行分析。
PD和RBD患者的元认知准确性与对照组受试者一致。然而，他们在各个认知领域的自信心较低，这反映了他们认知表现的下降。在他们的自信心与MDS-UPDRS I和II量表以及HADS焦虑和抑郁评分之间观察到显著的负相关。
我们的研究结果表明，早期至中期PD和RBD患者通常了解自己的认知状态，这与其他神经系统疾病不同。患者自信心与抑郁、焦虑症状以及日常生活挑战之间的负相关关系凸显了情绪和功能困难对他们认知能力自我认知的影响。这一见解对于理解这些病症如何影响心理健康可能具有重要意义，有助于临床医生制定更有效的患者护理策略。
