Metacognition and self-awareness in Multiple Sclerosis

Mazancieux, Audrey; Souchay, Céline; Casez, Olivier; Moulin, Chris J. A.

doi:10.1016/j.cortex.2018.11.012

Cited by 28 publications

(29 citation statements)

References 74 publications

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“…Although our sample of patients were more depressed and reported more fatigue than healthy control group participants, these variables were not correlated with the accuracy on the first prediction for the SDMT task. As we have previously suggested (Mazancieux et al 2019), depression and fatigue in MS could lead to an underestimation of performance. However, in the present study, patients on average predict the same number of items as healthy control group participants.…”

Section: Discussionmentioning

confidence: 70%

“…Patients' metacognitive knowledge was inaccurate, as gauged by the initial global predictions, for tasks before completing the task. As proposed in Mazancieux et al (2019), such predictions are more associated with mood variables (depression, anxiety, etc. ), fatigue, and self-esteem than with executive functions (that are more involved in monitoring processes).…”

Section: Discussionmentioning

confidence: 94%

“…The majority of studies investigating awareness in MS have focused on a comparison of self-evaluations of cognitive functioning (mainly by questionnaires) with more objective neuropsychological evaluations (e.g., Maor, Olmer, & Mozes, 2001;Randolph, Arnett, & Freske, 2004;Roberg, Bruce, Lovelace, & Lynch, 2012). In a recent review of the scant literature on metacognition in MS (Mazancieux et al, 2019), we suggested a non-linear relationship between the subjective evaluation of cognitive impairment and a more objective evaluation (i.e., neuropsychological assessment). Patients with a slight decline in their cognitive abilities tend to underestimate their abilities, whereas patients with more cognitive impairment tend to overestimate them.…”

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confidence: 99%

“…The focus of this paper is multiple sclerosis (MS). Whilst a considerable number of studies have examined the question of disease awareness in MS (for a review, see Mazancieux, Souchay, Casez & Moulin, 2019), most research has considered self-report and questionnaire measures. In this article, we invoke the metacognition framework to consider disease awareness in MS. Metacognition broadly refers to the knowledge of, the monitoring of (self-evaluation), and the control of (strategy implementation) cognitive activity (Nelson & Narens, 1990).…”

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confidence: 99%

“…On the contrary, sFOK accuracy is preserved in these studies. There is an overwhelming bias for measuring metacognition through memory tasks in MS (Mazancieux et al, 2019). As such, even though eFOK and sFOK tasks are robust and often used as measures of metacognition, memory function may not be the most pertinent task on which to test the metacognition of people with MS.…”

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confidence: 99%

See 4 more Smart Citations

A Multidimensional Assessment of Metacognition Across Domains in Multiple Sclerosis

Mazancieux

Moulin

Casez

et al. 2020

J Int Neuropsychol Soc

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Objective: In neurological diseases, metacognitive judgements have been widely used in order to assess the degree of disease awareness. However, as yet little research of this type has focused on multiple sclerosis (MS). Method: We here focused on an investigation of item-by-item metacognitive predictions (using feeling-of-knowing judgements) in episodic and semantic memory and global metacognitive predictions in standard neuropsychological tests pertinent to MS (processing speed and verbal fluency). Twenty-seven relapsing–remitting MS (RR-MS) patients and 27 comparison participants took part. Results: We found that RR-MS patients were as accurate as the group of comparison participants on our episodic and semantic item-by-item judgements. However, for the global predictions, we found that the MS group initially overestimated their performance (ds = .64), but only on a task on which performance was also impaired (ds = .89; processing speed). We suggest that MS patients, under certain conditions, show inaccurate metacognitive knowledge. However, postdictions and item-by-item predictions indicate that online metacognitive processes are no different from participants without MS. Conclusion: We conclude that there is no monitoring deficit in RR-MS and as such these patients should benefit from adaptive strategies and symptom education.

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Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 94%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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A Multidimensional Assessment of Metacognition Across Domains in Multiple Sclerosis

Mazancieux

Moulin

Casez

et al. 2020

J Int Neuropsychol Soc

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Impaired awareness: Why people with multiple sclerosis continue using cannabis despite evidence to the contrary

et al. 2021

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Background: With widespread moves toward legalization of cannabis, increasing numbers of people with multiple sclerosis (pwMS) are using the drug. Emerging MS-related data show that cannabis can cause or exacerbate cognitive dysfunction.Objective: To understand why people with MS continue using cannabis despite adverse cognitive consequences. It was hypothesized that lack of awareness, a component of metacognition, could explain this decision, in part.Method: Forty pwMS who smoked cannabis almost daily were assigned by odd-even case number selection to either a cannabis continuation (CC) or cannabis withdrawal (CW) group. Both groups were followed for 28 days. All participants completed, at baseline and day 28, the brief repeatable battery of neuropsychological tests (BRNB) in MS for measures of processing speed, memory and executive function; Modified fatigue impact scale (mFIS) for self-report indices of cognitive functioning. Results:No significant baseline differences between the groups on the BRNB and mFIS. At day 28, significant improvement within group was seen on all measures of the BRNB, but only in the CW group (p = .0001 for all indices). A repeat measure ANOVA did not find any significant group (CC vs. CW) × time (baseline and day 28) interactions for the self-report cognitive measures on the mFIS. Cannabis abstainers did report less ability to function away from home. All 19 participants in the CW group reverted to using cannabis on study completion despite being informed individually of their cognitive improvement. Conclusions and relevance:The inability of pwMS to accurately appraise their memory and executive function can help explain, in part, why they continue to smoke cannabis despite objective evidence of the deleterious cognitive side effects of this behavior.

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Retrospective confidence judgments: Meta‐analysis of functional magnetic resonance imaging studies

Martín-Luengo

Зинченко

Dolgoarshinnaia

et al. 2021

Human Brain Mapping

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Confidence in our retrieved memories, that is, retrospective confidence, is a metamemory process we perform daily. There is an abundance of applied research focusing on the metamemory judgments and very diverse studies including a wide range of clinical populations. However, the neural correlates that support its functioning are not well defined impeding the implementation of noninvasive neuromodulatory clinical interventions. To address the neural basis of metamemory judgments, we ran a meta‐analysis, where we used the activation likelihood estimation method on the 19 eligible functional magnetic resonance imaging studies. The main analysis of retrospective confidence revealed concordant bilateral activation in the parahippocampal gyrus, left middle frontal gyrus, and right amygdala. We also run an analysis between the two extreme levels of confidence, namely, high and low. This additional analysis was exploratory, since the minimum amount of articles reporting these two levels was not reached. Activations for the exploratory high > low confidence subtraction analysis were the same as observed in the main analysis on retrospective confidence, whereas the exploratory low > high subtraction showed distinctive activations of the right precuneus. The involvement of the right precuneus emphasizes its role in the evaluation of low confidence memories, as suggested by previous studies. Overall, our study contributes to a better understanding of the specific brain structures involved in confidence evaluations. Better understanding of the neural basis of metamemory might eventually lead to designing more precise neuromodulatory interventions, significantly improving treatment of patients suffering from metamemory problems.

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Metacognition and self-awareness in Multiple Sclerosis

Cited by 28 publications

References 74 publications

A Multidimensional Assessment of Metacognition Across Domains in Multiple Sclerosis

A Multidimensional Assessment of Metacognition Across Domains in Multiple Sclerosis

Impaired awareness: Why people with multiple sclerosis continue using cannabis despite evidence to the contrary

Retrospective confidence judgments: Meta‐analysis of functional magnetic resonance imaging studies

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