Given the success of the previous edition of this Research Topic, we are pleased to announce the release of its third volume.

Anosognosia or lack of awareness of a cognitive, behavioral or functional deficit is a very common symptom at the stage of dementia in many neurodegenerative diseases, e.g. Alzheimer’s disease and Frontotemporal dementia. Late diagnosis of the condition occurs frequently and this leads to a worse prognosis and less compliance with treatment or rehabilitation activities. Moreover, individuals who are unaware of their deficits may engage in activities well beyond their true functional capacity, thus becoming exposed to potentially dangerous situations. As such, caregivers of patients with anosognosia may experience a greater burden due to the need of increased supervision and control, often leading to early institutionalization.

Paradoxically, there is also evidence for a period in the Alzheimer’s disease spectrum where individuals may experience increased awareness of subtle changes in their memory function despite performing well on standardized tests (aka subjective cognitive decline). Right now, it is unknown if a person’s awareness changes across the disease spectrum and, if so, what the causes and underlying mechanisms of these changes are associated with. Thus, highlighting the importance of more studies that are investigating awareness and the concurrent association between subject and informant memory complaints across the disease trajectory in neurodegenerative diseases. In addition, despite the high impact of anosognosia on patients and their caregivers, our knowledge of its clinical and pathological correlates as well as prognostic value is poorly understood. Understanding the evolution and the cause of this disorder is crucial, not only for diagnostic purposes but also for its implications in patient treatment.

The aim of this Research Topic is to invite contributions that investigate the mechanism of anosognosia as well as the evolution of altered awareness across the different stages of neurodegenerative diseases. We will focus on the study of both cognitive/neuropsychological (e.g., memory, executive measures) and psycho-behavioral (e.g., personality types) determinants, biological correlates (e.g., structural and/or functional imaging, biomarkers), as well as anatomo-clinical studies. The focus of this collection will be twofold, targeting on the one hand on the comprehension of the bio-psycho-social determinants of the emergence of altered awareness of cognitive decline in the context of neurodegenerative pathologies, and on the other, the assessment of its predictive value — both diagnostic and prognostic. The results of these contributions are expected to increase our knowledge how brain disease leads to anosognosia, which could ultimately provide critical information about factors contributing to decline in functional status and loss of independence.

This Research Topic is widely open to contributions that address these above aims and target the following Topics:

• Neuropsychological, behavioral, and biological (i.e., neuroimaging, biomarkers) correlates of unawareness or heightened awareness in neurodegenerative diseases

• Innovative approaches to assess awareness for cognitive decline

• Longitudinal studies of the evolution of awareness throughout time

• Original cognitive and/or biological models explaining the mechanisms of awareness and its evolution in neurodegenerative diseases

• Intervention studies on the lack of awareness in neurodegenerative diseases

• Comparative studies on awareness between neurodegenerative diseases

• Comparative studies of awareness assessment methods

• Prognostic studies related awareness and further progression across the neurodegenerative spectrum

Are you interested in contributing a manuscript to this Research Topic?

To Know or Not to Know: Causes and Evolution of Lack of Awareness of Cognitive Decline in Neurodegenerative Diseases Vol III