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Metacognitive insight into cognitive performance in Huntington's disease gene carriers.

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cam.issuedOnline2022-04-05
dc.contributor.authorHewitt, Samuel Rc
dc.contributor.authorWhite, Alice J
dc.contributor.authorMason, Sarah L
dc.contributor.authorBarker, Roger A
dc.contributor.orcidHewitt, Samuel Rc [0000-0002-9219-6324]
dc.date.accessioned2022-05-27T01:02:59Z
dc.date.available2022-05-27T01:02:59Z
dc.date.issued2022
dc.date.updated2022-05-27T01:02:59Z
dc.description.abstractOBJECTIVES: Insight is an important predictor of quality of life in Huntington's disease and other neurodegenerative conditions. However, estimating insight with traditional methods such as questionnaires is challenging and subjected to limitations. This cross-sectional study experimentally quantified metacognitive insight into cognitive performance in Huntington's disease gene carriers. METHODS: We dissociated perceptual decision-making performance and metacognitive insight into performance in healthy controls (n=29), premanifest (n=19) and early-manifest (n=10) Huntington's disease gene carriers. Insight was operationalised as the degree to which a participant's confidence in their performance was informative of their actual performance (metacognitive efficiency) and estimated using a computational model (HMeta-d'). RESULTS: We found that premanifest and early-manifest Huntington's disease gene carriers were impaired in making perceptual decisions compared with controls. Gene carriers required more evidence in favour of the correct choice to achieve similar performance and perceptual impairments were increased in those with manifest disease. Surprisingly, despite marked perceptual impairments, Huntington's disease gene carriers retained metacognitive insight into their perceptual performance. This was the case after controlling for confounding variables and regardless of disease stage. CONCLUSION: We report for the first time a dissociation between impaired cognition and intact metacognition (trial-by-trial insight) in the early stages of a neurodegenerative disease. This unexpected finding contrasts with the prevailing assumption that cognitive deficits are associated with impaired insight. Future studies should investigate how intact metacognitive insight could be used by some early Huntington's disease gene carriers to positively impact their quality of life.
dc.identifier.doi10.17863/CAM.84943
dc.identifier.eissn2632-6140
dc.identifier.issn2632-6140
dc.identifier.other35463389
dc.identifier.otherPMC8987702
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/337528
dc.languageeng
dc.language.isoeng
dc.publisherBMJ
dc.publisher.urlhttp://dx.doi.org/10.1136/bmjno-2022-000268
dc.rightsAttribution 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.sourcenlmid: 101775450
dc.sourceessn: 2632-6140
dc.subjectCOGNITION
dc.subjectCOMPUTATIONAL PSYCHIATRY
dc.subjectHUNTINGTON'S
dc.titleMetacognitive insight into cognitive performance in Huntington's disease gene carriers.
dc.typeArticle
dcterms.dateAccepted2022-03-10
prism.issueIdentifier1
prism.publicationNameBMJ Neurol Open
prism.volume4
pubs.funder-project-idNational Institute for Health and Care Research (IS-BRC-1215-20014)
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by/4.0/
rioxxterms.versionVoR
rioxxterms.versionofrecord10.1136/bmjno-2022-000268

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