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@ARTICLE{Ye:285265,
author = {Ye, L. and Seidler, L. and Chemodanow, D. and Respondek, G.
and Niesmann, C. and Wilkens, I. and Klietz, M. and
Höglinger, G. U. and Kopp, B.},
title = {{E}xecutive anosognosia in progressive supranuclear palsy
versus {P}arkinson's disease.},
journal = {Frontiers in neurology},
volume = {17},
issn = {1664-2295},
address = {Lausanne},
publisher = {Frontiers Research Foundation},
reportid = {DZNE-2026-00207},
pages = {1744979},
year = {2026},
abstract = {Executive function deficits are common among patients with
Parkinson's disease (PD) and progressive supranuclear palsy
(PSP). Executive function refers to higher-order cognitive
processes thought to involve fronto-striatal circuits. Some
patients with executive deficits may be unable to recognize
or report them, a condition we refer to as executive
anosognosia.To conduct a comparative analysis of executive
anosognosia in patients diagnosed with PSP and PD.We
compared an objective neuropsychological assessment (ONA) of
composite executive function (ONA-CEF), which includes
semantic and phonemic verbal fluency, as well as two
sub-scores from the Wisconsin Card Sorting Test, with
patient- and informant-reported rating scales. We used the
Dysexecutive Questionnaire Revised (DEX-R) to evaluate
near-transfer executive complaints and the Aachen Activity
and Participation Index: Cognition and Participation
(AAPI-CP) composite to evaluate far-transfer cognitive and
social difficulties. Discrepancy indices were calculated for
patients and informants (ONA-CEF minus DEX-R and ONA-CEF
minus AAPI-CP).PSP patients had significantly larger
negative discrepancies than PD patients, indicating stronger
executive anosognosia. Although informant reports reduced
these discrepancies, significant underreporting persisted in
PSP informants. Correlational analyses revealed that
patient-reported DEX-R difficulties were strongly correlated
with depressive symptoms (r ≈ 0.65) but not with objective
executive performance (r ≈ 0.00).Executive anosognosia is
a marker of PSP, highlighting the need for objective
neuropsychological assessments in clinical trials. PSP
patients' reports of executive dysfunction are more
associated with mood than actual impairment, which
challenges the validity of patient-reported outcomes in PSP
and related neurological diseases.},
keywords = {Parkinson’s disease (Other) / anosognosia (Other) /
executive function (Other) / patient-reported outcome
measures (Other) / progressive supranuclear palsy (Other)},
cin = {Clinical Research (Munich)},
ddc = {610},
cid = {I:(DE-2719)1111015},
pnm = {353 - Clinical and Health Care Research (POF4-353)},
pid = {G:(DE-HGF)POF4-353},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:41704890},
pmc = {pmc:PMC12907162},
doi = {10.3389/fneur.2026.1744979},
url = {https://pub.dzne.de/record/285265},
}