{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:02:05Z","timestamp":1788411725457,"version":"build-2803163510"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Executive function deficits are common among patients with Parkinson\u2019s disease (PD) and progressive supranuclear palsy (PSP). Executive function refers to higher-order cognitive processes thought to involve fronto-striatal circuits. Some patients with executive deficits may be unable to recognize or report them, a condition we refer to as executive anosognosia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To conduct a comparative analysis of executive anosognosia in patients diagnosed with PSP and PD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We compared an objective neuropsychological assessment (ONA) of composite executive function (ONA-CEF), which includes semantic and phonemic verbal fluency, as well as two sub-scores from the Wisconsin Card Sorting Test, with patient- and informant-reported rating scales. We used the Dysexecutive Questionnaire Revised (DEX-R) to evaluate near-transfer executive complaints and the Aachen Activity and Participation Index: Cognition and Participation (AAPI-CP) composite to evaluate far-transfer cognitive and social difficulties. Discrepancy indices were calculated for patients and informants (ONA-CEF minus DEX-R and ONA-CEF minus AAPI-CP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      PSP patients had significantly larger negative discrepancies than PD patients, indicating stronger executive anosognosia. Although informant reports reduced these discrepancies, significant underreporting persisted in PSP informants. Correlational analyses revealed that patient-reported DEX-R difficulties were strongly correlated with depressive symptoms (\n                      <jats:italic>r<\/jats:italic>\n                      \u202f\u2248\u202f0.65) but not with objective executive performance (\n                      <jats:italic>r<\/jats:italic>\n                      \u202f\u2248\u202f0.00).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Executive anosognosia is a marker of PSP, highlighting the need for objective neuropsychological assessments in clinical trials. PSP patients\u2019 reports of executive dysfunction are more associated with mood than actual impairment, which challenges the validity of patient-reported outcomes in PSP and related neurological diseases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1744979","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T05:15:52Z","timestamp":1770009352000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Executive anosognosia in progressive supranuclear palsy versus Parkinson\u2019s disease"],"prefix":"10.3389","volume":"17","author":[{"given":"L.","family":"Ye","sequence":"first","affiliation":[{"name":"Department of Neurology, Hannover Medical School","place":["Hannover, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Seidler","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hannover Medical School","place":["Hannover, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Chemodanow","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hannover Medical School","place":["Hannover, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Respondek","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hannover Medical School","place":["Hannover, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Niesmann","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hannover Medical School","place":["Hannover, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Wilkens","sequence":"additional","affiliation":[{"name":"Department of Neurology, Ludwig-Maximilians-University of Munich","place":["Munich, Germany"]},{"name":"German Center for Neurodegenerative Diseases (DZNE)","place":["Munich, Germany"]},{"name":"Munich Cluster for Systems Neurology (SyNergy)","place":["Munich, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Klietz","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hannover Medical School","place":["Hannover, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. U.","family":"H\u00f6glinger","sequence":"additional","affiliation":[{"name":"Department of Neurology, Ludwig-Maximilians-University of Munich","place":["Munich, Germany"]},{"name":"German Center for Neurodegenerative Diseases (DZNE)","place":["Munich, Germany"]},{"name":"Munich Cluster for Systems Neurology (SyNergy)","place":["Munich, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Kopp","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hannover Medical School","place":["Hannover, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,2]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"753","DOI":"10.1093\/brain\/awl367","article-title":"Loss of insight in frontotemporal dementia, corticobasal degeneration and progressive supranuclear palsy","volume":"130","author":"O\u2019Keeffe","year":"2007","journal-title":"Brain"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1016\/j.parkreldis.2018.04.015","article-title":"Anosognosia for cognitive and behavioral symptoms in Parkinson\u2019s disease with mild dementia and mild cognitive impairment: frequency and neuropsychological\/neuropsychiatric correlates","volume":"54","author":"Orfei","year":"2018","journal-title":"Parkinsonism Relat Disord"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"920","DOI":"10.1080\/13803390801888733","article-title":"Self-reported executive dysfunction, neuropsychological impairment, and functional outcomes in multiple sclerosis","volume":"30","author":"Basso","year":"2008","journal-title":"J Clin Exp Neuropsychol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"684","DOI":"10.3390\/children9050684","article-title":"The discrepancy between actual performance and self-awareness among adolescents with executive function deficits","volume":"9","author":"Fogel","year":"2022","journal-title":"Children"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1016\/j.acn.2005.12.002","article-title":"Improving the ecological validity of executive functioning assessment","volume":"21","author":"Chaytor","year":"2006","journal-title":"Arch Clin Neuropsychol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"100293","DOI":"10.1016\/j.scog.2023.100293","article-title":"Self-report versus performance based executive functioning in people with psychotic disorders","volume":"34","author":"van Aken","year":"2023","journal-title":"Schizophr Res Cogn"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"3444","DOI":"10.1007\/s00415-021-10519-4","article-title":"Correlates of the discrepancy between objective and subjective cognitive functioning in non-demented patients with Parkinson\u2019s disease","volume":"268","author":"Siciliano","year":"2021","journal-title":"J Neurol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1244","DOI":"10.1017\/S0033291721002725","article-title":"Impaired self-awareness of cognitive deficits in Parkinson\u2019s disease relates to cingulate cortex dysfunction","volume":"53","author":"Maier","year":"2023","journal-title":"Psychol Med"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1007\/s11065-019-09410-x","article-title":"Functional neural correlates of Anosognosia in mild cognitive impairment and Alzheimer\u2019s disease: a systematic review","volume":"29","author":"Mondrag\u00f3n","year":"2019","journal-title":"Neuropsychol Rev"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1016\/j.neurobiolaging.2020.06.011","article-title":"What are the neural correlates of meta-cognition and anosognosia in Alzheimer\u2019s disease? A systematic review","volume":"94","author":"Hallam","year":"2020","journal-title":"Neurobiol Aging"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1517876","DOI":"10.3389\/fpsyg.2025.1517876","article-title":"Post-stroke lesion correlates of errors in verbal and spatial production tasks","volume":"16","author":"Visalli","year":"2025","journal-title":"Front Psychol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1097\/WNN.0b013e318145a6f6","article-title":"Relationship between self-reported apathy and executive dysfunction in nondemented patients with Parkinson disease","volume":"20","author":"Zgaljardic","year":"2007","journal-title":"Cogn Behav Neurol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"855664","DOI":"10.3389\/fneur.2022.855664","article-title":"Discrepancy between subjective and objective memory change after epilepsy surgery: relation with seizure outcome and depressive symptoms","volume":"13","author":"M\u00fccke","year":"2022","journal-title":"Front Neurol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"101644","DOI":"10.1016\/j.pneurobio.2019.101644","article-title":"Four-repeat tauopathies","volume":"180","author":"R\u00f6sler","year":"2019","journal-title":"Prog Neurobiol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"764","DOI":"10.1002\/mdc3.14348","article-title":"A short cognitive and neuropsychiatric assessment scale for progressive supranuclear palsy","volume":"12","author":"Porsche","year":"2025","journal-title":"Mov Disord Clin Pract"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1437","DOI":"10.1007\/s00702-019-02065-1","article-title":"Characteristics and progression of cognitive deficits in progressive supranuclear palsy vs. multiple system atrophy and Parkinson\u2019s disease","volume":"126","author":"Fiorenzato","year":"2019","journal-title":"J Neural Transm (Vienna)"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1080\/13803395.2019.1572073","article-title":"Cognitive deficits in progressive supranuclear palsy on the repeatable battery for the assessment of neuropsychological status","volume":"41","author":"Duff","year":"2019","journal-title":"J Clin Exp Neuropsychol"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"904","DOI":"10.1177\/1877718X251343080","article-title":"Associations between neuropsychological profile and regional brain FDG uptake in progressive supranuclear palsy","volume":"15","author":"Doll-Lee","year":"2025","journal-title":"J Parkinsons Dis"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"853","DOI":"10.1002\/mds.26987","article-title":"Clinical diagnosis of progressive supranuclear palsy: the movement disorder society criteria","volume":"32","author":"H\u00f6glinger","year":"2017","journal-title":"Mov Disord"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1591","DOI":"10.1002\/mds.26424","article-title":"MDS clinical diagnostic criteria for Parkinson\u2019s disease","volume":"30","author":"Postuma","year":"2015","journal-title":"Mov Disord"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1124","DOI":"10.1080\/09602011.2015.1121880","article-title":"The Dysexecutive questionnaire revised (DEX-R): an extended measure of everyday dysexecutive problems after acquired brain injury","volume":"27","author":"Simblett","year":"2017","journal-title":"Neuropsychol Rehabil"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"901","DOI":"10.1098\/rstb.2007.2096","article-title":"Is there a dysexecutive syndrome?","volume":"362","author":"Stuss","year":"2007","journal-title":"Philos Trans R Soc Lond Ser B Biol Sci"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"767367","DOI":"10.3389\/fnhum.2022.767367","article-title":"Psychometric properties of the revised Dysexecutive questionnaire in a non-clinical population","volume":"16","author":"Wakely","year":"2022","journal-title":"Front Hum Neurosci"},{"key":"ref24","first-page":"13","volume-title":"On the way to the NeuroCAT: development and initial evaluation of the Aachen-ADL-Itembank","author":"Boecker","year":"2010"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"322","DOI":"10.1159\/000357774","article-title":"The extension of the German CERAD neuropsychological assessment battery with tests assessing subcortical, executive and frontal functions improves accuracy in dementia diagnosis","volume":"4","author":"Schmid","year":"2014","journal-title":"Dement Geriatr Cogn Dis Extra"},{"key":"ref26","volume-title":"Modified Wisconsin card sorting test","author":"Schretlen","year":"2010"},{"key":"ref27","volume-title":"Behavioural assessment of the dysexecutive syndrome (BADS)","author":"Wilson","year":"1996"},{"key":"ref28","volume-title":"Manual for the beck depression inventory-II","author":"Beck","year":"1996"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"640137","DOI":"10.3389\/fneur.2021.640137","article-title":"Screen fast, screen faster: a pilot study to screen for depressive symptoms using the beck depression inventory fast screen in Parkinson\u2019s disease with mild cognitive impairment","volume":"12","author":"Elben","year":"2021","journal-title":"Front Neurol"},{"key":"ref30","volume-title":"Psychometric theory","author":"Nunnally","year":"1995"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1037\/0033-2909.87.2.245","article-title":"Tests for comparing elements of a correlation matrix","volume":"87","author":"Steiger","year":"1980","journal-title":"Psychol Bull"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"144","DOI":"10.3389\/978-2-88945-306-1","article-title":"Executive functions in psychiatric disorders","author":"Malloy-Diniz","year":"2017","journal-title":"Front Media SA"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"518","DOI":"10.1016\/S1474-4422(15)00019-8","article-title":"Apathy in Parkinson\u2019s disease: clinical features, neural substrates, diagnosis, and treatment","volume":"14","author":"Pagonabarraga","year":"2015","journal-title":"Lancet Neurol"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"983","DOI":"10.1007\/s00702-003-0011-0","article-title":"Differentiation of parkinsonian syndromes according to differences in executive functions","volume":"110","author":"Lange","year":"2003","journal-title":"J Neural Transm (Vienna)"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"107772","DOI":"10.1016\/j.neuropsychologia.2021.107772","article-title":"Phonemic fluency quantity and quality: comparing patients with PSP, Parkinson\u2019s disease and focal frontal and subcortical lesions","volume":"153","author":"Foley","year":"2021","journal-title":"Neuropsychologia"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1016\/j.neubiorev.2018.06.014","article-title":"Executive dysfunction in Parkinson\u2019s disease: a meta-analysis on the Wisconsin card sorting test literature","volume":"93","author":"Lange","year":"2018","journal-title":"Neurosci Biobehav Rev"},{"key":"ref37","year":""},{"key":"ref38","doi-asserted-by":"publisher","first-page":"e70082","DOI":"10.1002\/alz.70082","article-title":"Developing digital health technologies for frontotemporal degeneration","volume":"21","author":"Nevler","year":"2025","journal-title":"Alzheimers Dement"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1016\/j.jrp.2011.02.004","article-title":"A meta-analysis of the convergent validity of self-control measures","volume":"45","author":"Duckworth","year":"2011","journal-title":"J Res Pers"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"605","DOI":"10.1037\/neu0000681","article-title":"Executive functioning rating scales: ecologically valid or construct invalid?","volume":"34","author":"Soto","year":"2020","journal-title":"Neuropsychology"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1744979\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T05:15:54Z","timestamp":1770009354000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1744979\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,2]]},"references-count":40,"alternative-id":["10.3389\/fneur.2026.1744979"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2026.1744979","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,2]]},"article-number":"1744979"}}