PMID- 28843132
OWN - NLM
STAT- MEDLINE
DCOM- 20180601
LR  - 20180707
IS  - 1973-8102 (Electronic)
IS  - 0010-9452 (Linking)
VI  - 95
DP  - 2017 Oct
TI  - Henry, where have you lost your Self?
PG  - 37-50
LID - S0010-9452(17)30215-0 [pii]
LID - 10.1016/j.cortex.2017.06.019 [doi]
AB  - The Self is a complex construct encompassing distinct components, including 
      episodic and semantic autobiographical memory, the Self-concept, and the 
      subjective sense of Self, which highest level consists of Self-awareness. The 
      neuro-anatomical correlates are complex, and it is debated as to whether a common 
      region could support these different components of the Self, with a particular 
      interest for the cortical midline structures and the medial prefrontal cortex 
      (MPFC). Alzheimer's disease (AD) constitutes an interesting model for the study 
      of Self as autobiographical memory typically deteriorates as the disease 
      progresses. Here, we report the unexpected case of Henry, a patient with MCI due 
      to AD who was unable to produce any personal autobiographical memories, nor 
      describe his Self-concept, had a poor personal semantic memory, and disclosed 
      unusual anosognosia for this stage of the disease. His cognitive performance was 
      compared to a group of matched AD patients and a group of healthy controls 
      confirming that the main components of his Self were degraded. We hypothesized 
      that it was due to a marked atrophy within the cortical midline, as visually 
      assessed on his MRI. We further elucidated these findings through Voxel-based 
      morphometry analysis, which confirmed a significant atrophy of the MPFC that was 
      specific to this patient. Moreover, this revealed significant atrophy within the 
      bilateral insular cortex. Given the stage of the disease, the degradation of the 
      Self is unlikely to be accounted for by deficient mnemonic processes, especially 
      as the presence of discrete temporal atrophy was noted. We suggest that this 
      specific pattern of MPFC and insular atrophy is responsible for the systematic 
      collapse of the patient's Self, through the breakdown of the subjective sense of 
      Self, which is proposed as a prerequisite to all other components, according to 
      the model proposed by Prebble, Addis, and Tippett (2013).
CI  - Copyright (c) 2017 Elsevier Ltd. All rights reserved.
FAU - Philippi, Nathalie
AU  - Philippi N
AD  - Neurology Service, Neuropsychology Unit, University Hospital of Strasbourg, 
      Strasbourg, France; CMRR (Memory Resources and Research Centre), University 
      Hospital of Strasbourg, Strasbourg, France; ICube Laboratory (UMR 7357) and FMTS, 
      University of Strasbourg and CNRS, Strasbourg, France; Neuropsychology and 
      Pathophysiology of Schizophrenia (U1114), University of Strasbourg and INSERM, 
      Strasbourg, France. Electronic address: Nathalie.philippi@chru-strasbourg.fr.
FAU - Roquet, Daniel
AU  - Roquet D
AD  - ICube Laboratory (UMR 7357) and FMTS, University of Strasbourg and CNRS, 
      Strasbourg, France.
FAU - Ben Malek, Hedi
AU  - Ben Malek H
AD  - Neurology Service, Neuropsychology Unit, University Hospital of Strasbourg, 
      Strasbourg, France; CMRR (Memory Resources and Research Centre), University 
      Hospital of Strasbourg, Strasbourg, France; Neuropsychology and Pathophysiology 
      of Schizophrenia (U1114), University of Strasbourg and INSERM, Strasbourg, 
      France.
FAU - Noblet, Vincent
AU  - Noblet V
AD  - ICube Laboratory (UMR 7357) and FMTS, University of Strasbourg and CNRS, 
      Strasbourg, France.
FAU - Botzung, Anne
AU  - Botzung A
AD  - Neurology Service, Neuropsychology Unit, University Hospital of Strasbourg, 
      Strasbourg, France; CMRR (Memory Resources and Research Centre), University 
      Hospital of Strasbourg, Strasbourg, France.
FAU - Cretin, Benjamin
AU  - Cretin B
AD  - Neurology Service, Neuropsychology Unit, University Hospital of Strasbourg, 
      Strasbourg, France; CMRR (Memory Resources and Research Centre), University 
      Hospital of Strasbourg, Strasbourg, France.
FAU - Blanc, Frederic
AU  - Blanc F
AD  - CMRR (Memory Resources and Research Centre), University Hospital of Strasbourg, 
      Strasbourg, France; ICube Laboratory (UMR 7357) and FMTS, University of 
      Strasbourg and CNRS, Strasbourg, France; Geriatrics Department, University 
      Hospital of Strasbourg, Strasbourg, France.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20170714
PL  - Italy
TA  - Cortex
JT  - Cortex; a journal devoted to the study of the nervous system and behavior
JID - 0100725
SB  - IM
MH  - Aged
MH  - Alzheimer Disease/diagnostic imaging/*psychology
MH  - Brain/diagnostic imaging
MH  - Cognitive Dysfunction/diagnostic imaging/*psychology
MH  - Humans
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Memory, Episodic
MH  - Metacognition/physiology
MH  - Neuropsychological Tests
MH  - *Self Concept
OTO - NOTNLM
OT  - Alzheimer's disease
OT  - Autobiographical memory
OT  - Case-report
OT  - Insula
OT  - Medial prefrontal cortex
OT  - Self
EDAT- 2017/08/27 06:00
MHDA- 2018/06/02 06:00
CRDT- 2017/08/27 06:00
PHST- 2016/12/18 00:00 [received]
PHST- 2017/06/16 00:00 [revised]
PHST- 2017/06/26 00:00 [accepted]
PHST- 2017/08/27 06:00 [pubmed]
PHST- 2018/06/02 06:00 [medline]
PHST- 2017/08/27 06:00 [entrez]
AID - S0010-9452(17)30215-0 [pii]
AID - 10.1016/j.cortex.2017.06.019 [doi]
PST - ppublish
SO  - Cortex. 2017 Oct;95:37-50. doi: 10.1016/j.cortex.2017.06.019. Epub 2017 Jul 14.