Evidence and implications of abnormal predictive coding in dementia
Open accessAbstract
The diversity of cognitive deficits and neuropathological processes associated with dementias has encouraged divergence in pathophysiological explanations of disease. Here, we review an alternative framework that emphasizes convergent critical features of cognitive pathophysiology. Rather than the loss of ‘memory centres’ or ‘language centres’, or singular neurotransmitter systems, cognitive deficits are interpreted in terms of aberrant predictive coding in hierarchical neural networks. This builds on advances in normative accounts of brain function, specifically the Bayesian integration of beliefs and sensory evidence in which hierarchical predictions and prediction errors underlie memory, perception, speech and behaviour. We describe how analogous impairments in predictive coding in parallel neurocognitive systems can generate diverse clinical phenomena, including the characteristics of dementias. The review presents evidence from behavioural and neurophysiological studies of perception, language, memory and decision-making. The reformulation of cognitive deficits in terms of predictive coding has several advantages. It brings diverse clinical phenomena into a common framework; it aligns cognitive and movement disorders; and it makes specific predictions on cognitive physiology that support translational and experimental medicine studies. The insights into complex human cognitive disorders from the predictive coding framework may therefore also inform future therapeutic strategies.
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Disruption to this mechanism may impair signal processing and perception in a noisy environment, as observed in AD.
“Disruption to this mechanism may impair signal processing and perception in a noisy environment, 6 as observed in AD. 6”
From Alzheimer's disease and its progression reduce pyramidal cell gain and connectivity (2025) · cites this paper as [6]
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A predictive coding framework of allostatic–interoceptive overload in frontotemporal dementia
Migeot, J. A., Duran-Aniotz, C. A., Signorelli, C. M., Piguet, O., & Ibáñez, A. (2022) · Trends in Neurosciences · doi:10.1016/j.tins.2022.08.005 · Cited by 76 · see citing works
Intrinsic timescales and predictive allostatic interoception in brain health and disease
Ibanez, A., & Northoff, G. (2024) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2023.105510 · Cited by 36 · see citing works
Neurophysiological consequences of synapse loss in progressive supranuclear palsy
Adams, N. E., Jafarian, A., Perry, A., Rouse, M. A., Shaw, A. D., Murley, A. G., Cope, T. E., Bevan-Jones, W. R., Passamonti, L., Street, D., et al. (2023) · Brain · doi:10.1093/brain/awac471 · Cited by 21 · see citing works
Self-citationProcessing of Degraded Speech in Brain Disorders
Jiang, J., Benhamou, E., Waters, S., Johnson, J. C. S., Volkmer, A., Weil, R. S., Marshall, C. R., Warren, J. D., & Hardy, C. J. D. (2021) · Brain Sciences · doi:10.3390/brainsci11030394 · Cited by 17 · see citing works
Hazelton, J. L., Carneiro, F., Maito, M., Richter, F., Legaz, A., Altschuler, F., Cubillos-Pinilla, L., Chen, Y., Doherty, C. P., Baez, S., et al. (2025) · Biological Psychiatry · doi:10.1016/j.biopsych.2024.10.013 · Cited by 21 · see citing works
Perry, A., Hughes, L. E., Adams, N., Naessens, M., Murley, A. G., Rouse, M. A., Street, D., Jones, P. S., Cope, T., Kocagöncü, E., et al. (2022) · Translational Psychiatry · doi:10.1038/s41398-022-02114-6 · Cited by 14 · see citing works
Self-citationAllostatic interoception and brain health: From neurodegeneration to social adversities
Migeot, J., & Ibáñez, A. (2025) · Encyclopedia of the Human Brain · doi:10.1016/b978-0-12-820480-1.00025-5 · Cited by 10 · see citing works
Greater tau pathology is associated with altered predictive coding
Gjini, K., Casey, C., Tanabe, S., Bo, A., Parker, M., White, M., Kunkel, D., Lennertz, R., Pearce, R. A., Betthauser, T., et al. (2022) · Brain Communications · doi:10.1093/braincomms/fcac209 · Cited by 9 · see citing works
Alzheimer's disease and its progression reduce pyramidal cell gain and connectivity
Lanskey, J. H., Jafarian, A., Karadag, M., Kocagoncu, E., Williams, R. S., Yadav, P., Quinn, A. J., Pitt, J., Thayanandan, T., Lowe, S., et al. (2025) · Alzheimer's & Dementia · doi:10.1002/alz.70805 · Cited by 2 · see citing works
“6 The precision of prediction errors is proposed to be encoded by the gain modulation of pyramidal cells in superficial layers of cortex.”
Self-citationA neuroanatomical and cognitive model of impaired social behaviour in frontotemporal dementiaPreprint
Rouse, M. A., Binney, R. J., Patterson, K. E., Rowe, J. B., & Ralph, M. A. L. (2023) · doi:10.31234/osf.io/b3kt6 · Cited by 2 · see citing works
Self-citation
- Authors
- Kocagoncu, E., Klimovich-Gray, A., Hughes, L. E., & Rowe, J. B.
- Affiliations
- Cambridge Centre for Frontotemporal Dementia, Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 0SZ, UK
- Basque Centre on Cognition, Brain and Language, San Sebastian 20009, Spain
- MRC Cognition and Brain Sciences Unit (GB)
- Venue
- Brain
- Publisher
- Oxford University Press (OUP)
- Published
- 2021-07-08
- Volume
- 144
- Issue
- 11
- Pages
- 3311-3321
- ISSN
- 0006-8950 (ISSN-L)
- 1460-2156
- PMC
- PMC8677549
- OpenAlex
- W3034547662
- Cited by
- 3
- References
- 210
- Citations by year
- 2023: 1 · 2022: 1 · 2021: 1
- FWCI
- 0.11
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Brain (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- arXiv (Cornell University) (submittedVersion)
- Communities in ADDI (Universidad del Pais Vasco) (submittedVersion, cc-by)
- Aberdeen University Research Archive (Aberdeen University) (submittedVersion)
- Apollo (University of Cambridge) (submittedVersion)
- arXiv (Cornell University)
- Apollo
- Funders
- Dementias Platform UK and Alzheimer’s Research UK (RG94383, RG89702)
- Wellcome Trust (103838)
- Medical Research Council (SUAG/051 G101400)
- National Institute for Health Research Cambridge Biomedical Research Centre
- European Union’s Horizon 2020 Research and Innovation Programme
- Marie Skłodowska-Curie (798971)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Embodied and Extended Cognition
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neurobiology of Language and Bilingualism
- Keywords
- predictive coding, dementia, Bayesian brain, prediction error, hierarchical neural networks, memory, perception, language, decision-making, cognitive impairment, neurodegenerative diseases
- MeSH terms
- Brain, Cognition, Dementia, Humans
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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