AUTHOR=Bălăeţ Maria , Alhajraf Falah , Bourke Niall J. , Welch Jessica , Razzaque Jamil , Malhotra Paresh , Hu Michele T. , Hampshire Adam 

TITLE=Metacognitive accuracy differences in Parkinson’s disease and REM sleep behavioral disorder relative to healthy controls

JOURNAL=Frontiers in Neurology

VOLUME=Volume 15 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2024.1399313

DOI=10.3389/fneur.2024.1399313

ISSN=1664-2295

ABSTRACT=Background: 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 behavioural disorder (RBD), a prodrome of PD.Objectives: This study aimed to evaluate metacognitive accuracy and self-confidence in PD and RBD patients across various cognitive tasks.Methods: We conducted detailed computerised 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 analysed against clinical and mental health factors.Results: 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.Conclusions: 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.