J Neurol Neurosurg Psychiatry 84:121 doi:10.1136/jnnp-2012-303571
  • Editorial commentaries

The role of the subgenual cingulate cortex in self-appraisal

  1. Yolande Pijnenburg3
  1. 1Department of Neurology, Erasmus Medical Centre, Amsterdam, The Netherlands
  2. 2Alzheimer center and Department of Clinical Genetics, VU medical centre, Amsterdam, The Netherlands
  3. 3Department of Neurology, Alzheimercenter VU medical centre, Amsterdam, The Netherlands
  1. Correspondence to Dr John C van Swieten, Department of Neurology, Erasmus Medical Centre, VU medical centre, Amsterdam, The Netherlands; j.c.vanswieten{at}
  • Received 24 August 2012
  • Accepted 28 August 2012
  • Published Online First 2 October 2012

The neural basis of multidomain self-appraisal deficits in frontotemporal dementia

Loss of insight, defined as a lack of awareness of cognitive deficits or behavioural changes, is one of the most salient clinical features in frontotemporal dementia (FTD).1 A significant proportion of patients with Alzheimer's disease (AD) also display this phenomenon, and its neuroanatomical correlates have been the focus of recent research.2

In the first place, knowledge about insight in dementia is important for managing issues, as disturbed insight negatively influences adaptation behaviour. Moreover, studying insight can teach us a lot about brain–behaviour relationships. Self-appraisal is a metacognitive function specific to human beings, implicating the capacity to evaluate one's cognitive performance. It is closely related to the processes of selection, monitoring and …

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