Metacognition is interesting, but is it also important? Might some clinical conditions be explained by metacognitive deficits?
The two papers we published so far do not (yet) paint a clear picture. We'll continue to ask questions like these, hoping to contribute
to a better understainding and potentially amelioration of patients' life quality.
It had been suggested that some symptoms that people with tic disorders and TD experience might result from a dissociation between sensory processing, measured
objectively, and patients’ subjective reports. For example, patients with TD describe their subjective experience as an increased sensitivity to external stimuli,
like cutaneous or olfactory stimuli. But one previous paper had shown that their objective perception thresholds are indistinguishable from a comparable sample of healthy volunteers.
This discrepancy could be seen as a dissociation between objective response accuracy and subjective reports may manifest as lower metacognitive sensitivity. So, we collaborated with
Christos Ganos to measure
patients with TD in their ability to metacognitively monitor visual and tactile stimuli.
Perhaps confusingly, and against our hypotheses, we found no evidence for a difference between groups of volunteers. The question on the pathogenesis of TD remains open.
Functional motor disorders are another case in which patients' subjective experience dissociates from objective markers. For examples, movements are
experienced as involuntary, but show some characteristics of voluntary movement. So, here as well we reasoned that metacoginitive measures could reveal,
and maybe help us understand, these dissociations between subjective and objective measures.
Julius Verrel led the project and found that, indeed, patients with FMD had both lower sensitivity
in discriminating their movements from slightly altered versions of the same movements, and — once we accounted for this — they had lower metacognitive sensitivity in
the discrimination task.