{
  "abstract": "Anosognosia, or unawareness of one’s deficits, predicts faster clinical progression in Alzheimer’s disease (AD), though its mechanisms remain unclear. We investigated five-year trajectories of response awareness and error-monitoring efficiency using second-order judgments from an annual word recognition memory task in cognitively unimpaired individuals at risk for AD from the INSIGHT-preAD cohort. Participants were divided into three groups according to amyloid status at baseline (positive, A + ; negative, A–) and clinical progression (controls, CTRL A+ or A–; and progressors, PROG). Task accuracy declined in PROG, while CTRL A+ showed continued learning, and CTRL A– remained accurate. Inefficient error-monitoring predicted subsequent performance decline in the PROG, with a strong interaction between accuracy and error-monitoring already at baseline. This effect was primarily driven by error unawareness. These findings provide first evidence that error unawareness — a core feature of anosognosia — may foster cognitive decline through the disruption of error-feedback learning mechanisms, potentially accelerating AD progression. This study advances understanding of AD progression by linking anosognosia-related error unawareness to disrupted error-feedback learning and cognitive decline from the preclinical stage, with implications for disease modeling, prognosis, and therapy.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "name": "Katia Andrade"
    },
    {
      "name": "François-Xavier Lejeune"
    },
    {
      "name": "Nesma Houmani"
    },
    {
      "name": "Rita Yabouri"
    },
    {
      "name": "Michel Thiebaut de Schotten"
    },
    {
      "name": "Valentina Pacella"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/3n2yra6r8cpk2.bib",
  "cited_by": 0,
  "doi": "10.1038/s42003-026-10461-z",
  "fulltext_url": null,
  "id": "3n2yra6r8cpk2",
  "issns": [
    "2399-3642"
  ],
  "landing_url": "https://hal.science/hal-05852649v1",
  "language": "en",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "hal",
      "0.sdv"
    ],
    [
      "hal",
      "1.sdv.neu"
    ],
    [
      "openalex",
      "2738|Dementia and Cognitive Impairment Research"
    ]
  ],
  "openalex": "W7164328842",
  "pdf_url": "https://www.nature.com/articles/s42003-026-10461-z_reference.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-06-11",
  "publisher": "Nature Publishing Group",
  "ris": "https://research.draconitic.com/paper/3n2yra6r8cpk2.ris",
  "sources": [
    {
      "first_seen": "2026-11-05T12:20:13Z",
      "native_id": "hal-05852649",
      "source": "hal",
      "url": "https://hal.science/hal-05852649v1"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "hal:1.sdv.neu",
      "subfield": "neuroscience"
    }
  ],
  "title": "Error unawareness as a driver of cognitive decline in individuals at risk for Alzheimer’s disease",
  "title_text": "Error unawareness as a driver of cognitive decline in individuals at risk for Alzheimer’s disease",
  "type": "peer-reviewed",
  "updated_at": "2026-11-06T12:20:44Z",
  "url": "https://research.draconitic.com/paper/3n2yra6r8cpk2",
  "venue": "Communications Biology",
  "versions": []
}