Dopamine effects on memory load and distraction during visuospatial working memory in cognitively normal Parkinson’s disease

Abstract Background Mild cognitive impairment (MCI) is a common symptom in the patients with Parkinson’s disease (PD). The characteristics of cognitive impairment in PD are executive function (including working memory) and visuo-perceptual processing. The visuospatial n-back test has the merit of minimizing the influence of educational biases involved in the verbal n-back test. Furthermore, it can assess both visuospatial recognition and working memory in a single test. Methods We aimed to clarify the advantage of the visuospatial n-back test as a tool for detecting impairments of working memory in PD. We enrolled 28 right-handed patients with PD (18 males, 10 females) and 12 age-matched healthy controls (HC; 7 males, 5 females). Thirteen patients were classified as MCI (PD-MCI), and 15 as cognitively normal PD (PD-CN). Using functional MRI (fMRI), we explored the specific brain regions associated with the performance of the n-back test in the PD-MCI, PD-CN, and HC groups. The 0-back test assesses visuospatial recognition, while the 1-back and 2-back tests assess visuospatial working memory. Group comparisons were performed for three loads of this test. Results Patients with PD performed significantly worse in terms of the correct answer rates of all n-back tests compared with HC. fMRI analyses performed during the 2-back test revealed reduced activation in the bilateral dorsolateral prefrontal cortex, middle frontal gyrus (MFG), and parietal lobule in the PD group compared with the HC group. In contrast, the fMRI result during the 0-back test showed only a marginal difference in the frontal lobe. On comparisons of task performance between the PD-MCI and PD-CN groups, we found that the correct answer rate in the 2-back test was lower in the PD-MCI group than in the PD-CN group. However, scores of the 0-back and 1-back tests were not significantly different between the two groups. The fMRI findings revealed that activations within the middle frontal gyrus (MFG) and inferior parietal lobule (IPL) during the 2-back test were reduced in the patients with PD-MCI when compared to those with PD-CN. Conclusions This study reports reduced activation of the MFG and IPL in patients with PD-MCI. These regions may be associated with the pathophysiology of working memory impairment in patients with PD, which involves fronto-striatal network dysfunction.

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Patients with Parkinson’s Disease Show Alteration in their Visuospatial Abilities and in their Egocentric and Allocentric Spatial Orientation Measured by Card Placing Tests

Journal of Parkinson s Disease ◽

10.3233/jpd-202122 ◽

2020 ◽

Vol 10 (4) ◽

pp. 1807-1816

Author(s):

Cristina Fernandez-Baizan ◽

M. Paula Fernandez Garcia ◽

Elena Diaz-Caceres ◽

Manuel Menendez-Gonzalez ◽

Jorge L. Arias ◽

...

Keyword(s):

Parkinson’S Disease ◽

Working Memory ◽

Parkinson's Disease ◽

Spatial Orientation ◽

Visuospatial Working Memory ◽

Dominant Group ◽

Visuospatial Abilities ◽

Visuospatial Skills ◽

Visuospatial Functions ◽

Do So

Background: Visuospatial skills are impaired in Parkinson’s disease (PD). Other related skills exist, such as spatial orientation have been poorly studied. The egocentric (based on internal cues) and allocentric frameworks (based on external cues) are used in daily spatial orientation. Depending on PD onset, the allocentric framework may have a higher level of impairment in tremor-dominant and the egocentric one in akinetic-rigid. Objective: To evaluate spatial orientation and visuospatial functions in PD patients and controls, and to assess whether their performance is related to disease duration and the PD subtype (tremor-dominant and akinetic-rigid). Methods: We evaluated egocentric and allocentric spatial orientation (Egocentric and Allocentric Spatial Memory Tasks) and visuospatial abilities, span and working memory in 59 PD patients and 51 healthy controls. Results: Visuospatial skills, visuospatial span, and egocentric and allocentric orientation are affected in PD. Visuospatial skills and allocentric orientation undergo deterioration during the first 5 years of the disease progression, while egocentric orientation and visuospatial span do so at later stages (9–11 years). The akinetic-rigid subtype presents worse results in all the spatial abilities that were measured when compared to controls, and worse scores in visuospatial working memory, visuospatial abilities and allocentric orientation when compared to the tremor-dominant group. The tremor-dominant group performed worse than controls in egocentric and allocentric orientation. Conclusion: PD patients show deficits in their visuospatial abilities and in their egocentric and allocentric spatial orientation compared to controls, specifically in akinetic-rigid PD. Only spatial orientation are affected in tremor-dominant PD patients. Allocentric orientation is affected earlier in the progression of the disease.

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The role of executive processes in working memory deficits in Parkinson’s Disease

Polish Psychological Bulletin ◽

10.1515/ppb-2016-0013 ◽

2016 ◽

Vol 47 (1) ◽

pp. 123-130 ◽

Cited By ~ 4

Author(s):

Aleksandra Gruszka ◽

Daniel Bor ◽

Roger R. Barker ◽

Edward Necka ◽

Adrian M. Owen

Keyword(s):

Parkinson’S Disease ◽

Working Memory ◽

Parkinson's Disease ◽

Spatial Working Memory ◽

Clinical Symptoms ◽

Memory Load ◽

Memory Task ◽

Verbal Working Memory ◽

Memory Deficits ◽

Exact Nature

Abstract Idiopathic Parkinson’s disease (PD) impairs working memory, but the exact nature of this deficit in terms of the underlying cognitive mechanisms is not well understood. In this study patients with mild clinical symptoms of PD were compared with matched healthy control subjects on a computerized battery of tests designed to assess spatial working memory and verbal working memory. In the spatial working memory task, subjects were required to recall a sequence of four locations. The verbal working memory task was methodologically identical except for the modality of the stimuli used, requiring subjects to orally recall a sequence of six digits. In either case, half of the sequences were structured in a way that allowed ‘chunking’, while others were unstructured. This manipulation was designed to dissociate the strategic component of task performance from the memory-load component. Mild medicated patients with PD were impaired only on the structured versions of the verbal working memory tasks. The analogous deficit in the spatial working memory was less pronounced. These findings are in agreement with the hypothesis that working memory deficits in PD reflect mainly the executive component of the tasks and that the deficits may be at least partly modality-independent.

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Visuospatial n-back test for early detection of mild cognitive impairment in patients with Parkinson’s Disease : an fMRI study

10.1101/2020.03.03.974725 ◽

2020 ◽

Author(s):

Shoji Kawashima ◽

Yoko Shimizu ◽

Yoshino Ueki ◽

Noriyuki Matsukawa

Keyword(s):

Parkinson’S Disease ◽

Working Memory ◽

Parkinson's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Early Detection ◽

Functional Neuroimaging ◽

Common Symptom ◽

Visuospatial Working Memory ◽

Increased Risk

AbstractBackgroundCognitive impairment is a common symptom in the patients with Parkinson’s disease (PD). In delineating a therapeutic plan, the early diagnosis of mild cognitive impairment in PD (PD-MCI) is important. Patients with PD-MCI have severe impairment in frontal executive function and/or visuospatial recognition. However, the clinical assessment of these functions is not routinely performed.MethodIn this study, we aimed to clarify the advantage of visuospatial version of the n-back test as a tool for the early detection of neuropsychological change in the patients with PD-MCI. The score of 0-back test reflects visuospatial recognition, and the scores of 1-back and 2-back reflect visuospatial working memory. PD-MCI was classified according to the criteria provided by the Movement Disorder Society Task Force for mild cognitive impairment in PD. We recruited 13 patients with PD-MCI, and 15 patients with cognitive normal PD. Using functional MRI (fMRI), we also aimed to clarify the specific brain regions associated with the impairment of visuospatial working memory.ResultWe demonstrated that the correct answer rate of patients with PD-MCI was lower in the 2-back test than patients with PD-CN. However, we did not find statistical difference in the 0-back test. These results indicate the preservation of visuospatial recognition and the impairment of visuospatial working memory in the patients with PD-MCI. We revealed the reduced activation within the middle frontal gyrus (MFG) and the inferior parietal lobule (IPL) during the 2-back test in the patients with PD-MCI. It may be associated with the severity of cortico-striatal dysfunction in the dopaminergic neural network which is associated with Lewy body pathology.ConclusionThe visuospatial n-back test has advantages for use in rapid and early detection of impaired visual recognition and working memory. The combination of functional neuroimaging and neuropsychological tests may provide markers for the increased risk of dementia before the development of an irreversible disease-specific pathology.

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Impairment of the visuospatial working memory in the patients with Parkinson’s Disease: an fMRI study

10.21203/rs.3.rs-120393/v1 ◽

2020 ◽

Author(s):

Shoji Kawashima ◽

Yoko Shimizu ◽

Yoshino Ueki ◽

Noriyuki Matsukawa

Keyword(s):

Parkinson’S Disease ◽

Working Memory ◽

Parkinson's Disease ◽

Functional Neuroimaging ◽

Brain Regions ◽

Common Symptom ◽

Visuospatial Working Memory ◽

Fmri Study ◽

Neuropsychological Characteristics ◽

Normal Ageing

Abstract Background: Mild cognitive impairment (MCI) is a common symptom in the patients with Parkinson’s disease (PD). MCI is a transitional stage between normal ageing and dementia. The neuropsychological characteristics of the PD-MCI are impairment in frontal executive function and/or visuospatial working memory. The newly modified version of the n-back test, visuospatial n-back test can assess both visuospatial recognition and visuospatial working memory. Methods: In this study, we aimed to clarify the advantage of visuospatial n-back test as a tool for the detection of the impairment of working memory in the patients with PD. Using functional MRI, we aimed to search the specific brain regions associated with the impairment of visuospatial working memory. The score of 0-back reflects visuospatial recognition, and the scores of 1-back and 2-back reflect visuospatial working memory. We recruited 13 patients with PD-MCI, and 15 patients with cognitive normal PD (PD-CN). Group comparisons between PD-MCI and PD-CN were performed for three loads of this test. The correlations between the scores of n-back test and task-related activations were analysed for all patients. Results: We found that the correct answer rate of patients with PD-MCI was lower in the 2-back test than those with PD-CN. However, scores of the 0-back and 1-back tests were not different between the groups. The result of fMRI showed that the activations within the middle frontal gyrus (MFG) and the inferior parietal lobule (IPL) during the 2-back test were reduced in the patients with PD-MCI.Conclusions: This study revealed an impaired visuospatial working memory in PD-MCI in association with the reduced activations of MFG and IPL. Combinations of functional neuroimaging and the visuospatial n-back test are beneficial to evaluate the impairment of working memory in PD.

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Abnormal distraction and load‐specific connectivity during working memory in cognitively normal Parkinson's disease

Human Brain Mapping ◽

10.1002/hbm.24868 ◽

2019 ◽

Vol 41 (5) ◽

pp. 1195-1211

Author(s):

Deborah L. Harrington ◽

Qian Shen ◽

Julian Vincent Filoteo ◽

Irene Litvan ◽

Mingxiong Huang ◽

...

Keyword(s):

Parkinson’S Disease ◽

Working Memory ◽

Parkinson's Disease ◽

Cognitively Normal

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Memantine for the Patients with Mild Cognitive Impairment in Parkinson’s Disease: A Pharmacological fMRI Study

10.21203/rs.3.rs-967500/v1 ◽

2021 ◽

Author(s):

Shoji Kawashima ◽

Noriyuki Matsukawa ◽

RCIP-Nagoya Study Group

Keyword(s):

Parkinson’S Disease ◽

Working Memory ◽

Parkinson's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Spatial Working Memory ◽

Clinical Status ◽

Visuospatial Working Memory ◽

Increased Risk ◽

The Impact

Abstract Background:Mild cognitive impairment of Parkinson’s disease (PD-MCI) represents increased risk of future cognitive decline. The characteristics of PD-MCI are impairments in executive function and visuospatial recognition. The visuospatial n-back test has a merit that it can assess both cognitive domains. Concerning the treatment of PD-MCI and dementia in PD (PDD), many studies have reported efficacy of cholinesterase inhibitors. Similarly, some studies reported efficacy of memantine for PDD, showing that it improved clinical status or behavioral symptoms. However, therapeutic evidence of memantine for PD-MCI has not been unestablished. Methods: We aimed to investigate whether memantine can alter brain function of the patients with PD-MCI, using functional MRI. In comparison between memantine and placebo, we explored the difference in regions associated with visuospatial n-back test. The 0-back test reflects visuospatial recognition, and the 1-back and 2-back tests reflect visuospatial working memory. This study followed a randomized double-blind crossover design. Patients in the memantine group were given memantine at 5 mg/day in the first week, and the dose was increased by 5 mg/day per week, with the final dose of 20 mg/day. The patients in the placebo group were given a placebo following the same regimen. The population in this study constitutes 10 patients who completed follow-up. During maximum dose administration, fMRI scanning and neuropsychological tests were performed. Group comparisons between memantine and placebo were performed.Results: There were no significant regions enhanced by memantine comparing with placebo at any load of n-back tests. In contrast, exploring regions reduced by memantine, we found significant reduction of activations within right lingual gyrus and left superior frontal gyrus in comparison between 2-back and 0-back test. A number of correct answers of the 2-back test and time to complete Trail Making Test-A were worse at memantine intervention. Reduced brain activations were associated with worse visuo-spatial working memory caused by memantine.Conclusions:This study reports memantine did not improve visuospatial working memory of the patients with PD-MCI. Treatment of PD should be planned carefully considering the impact for cognitive function. Further study is needed to establish new therapeutic strategy of the patients with PD-MCI.

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Visual Search Facilitation in Repeated Displays Depends on Visuospatial Working Memory

Experimental Psychology (formerly Zeitschrift für Experimentelle Psychologie) ◽

10.1027/1618-3169/a000125 ◽

2012 ◽

Vol 59 (1) ◽

pp. 47-54 ◽

Cited By ~ 16

Author(s):

Angela A. Manginelli ◽

Franziska Geringswald ◽

Stefan Pollmann

Keyword(s):

Working Memory ◽

Visual Search ◽

Control Experiment ◽

Memory Load ◽

Contextual Cueing ◽

Long Term Memory ◽

Visuospatial Working Memory ◽

Working Memory Load ◽

Memory Resources

When distractor configurations are repeated over time, visual search becomes more efficient, even if participants are unaware of the repetition. This contextual cueing is a form of incidental, implicit learning. One might therefore expect that contextual cueing does not (or only minimally) rely on working memory resources. This, however, is debated in the literature. We investigated contextual cueing under either a visuospatial or a nonspatial (color) visual working memory load. We found that contextual cueing was disrupted by the concurrent visuospatial, but not by the color working memory load. A control experiment ruled out that unspecific attentional factors of the dual-task situation disrupted contextual cueing. Visuospatial working memory may be needed to match current display items with long-term memory traces of previously learned displays.

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Evaluation of Motor and Cognitive Performance in People with Parkinson’s Disease Using Instrumented Trail-Making Test

Gerontology ◽

10.1159/000515940 ◽

2021 ◽

pp. 1-7

Author(s):

Ram kinker Mishra ◽

Catherine Park ◽

He Zhou ◽

Bijan Najafi ◽

T. Adam Thrasher

Keyword(s):

Older Adults ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cognitive Performance ◽

Pairwise Comparison ◽

Walking Test ◽

Cognitively Normal ◽

Early Results ◽

Trail Making ◽

Changes Over Time

Introduction: Parkinson’s disease (PD) progressively impairs motor and cognitive performance. The current tools to detect decline in motor and cognitive functioning are often impractical for busy clinics and home settings. To address the gap, we designed an instrumented trail-making task (iTMT) based on a wearable sensor (worn on the shin) with interactive game-based software installed on a tablet. The iTMT test includes reaching to 5 indexed circles, a combination of numbers (1–3) and letters (A&B) randomly positioned inside target circles, in a sequential order, which virtually appears on a screen kept in front of the participants, by rotating one’s ankle joint while standing and holding a chair for safety. By measuring time to complete iTMT task (iTMT time), iTMT enables quantifying cognitive-motor performance. Purpose: This study’s objective is to examine the feasibility of iTMT to detect early cognitive-motor decline in PDs. Method: Three groups of volunteers, including 14 cognitively normal (CN) older adults, 14 PDs, and 11 mild cognitive impaireds (MCI), were recruited. Participants completed MoCA, 20 m walking test, and 3 trials of iTMT. Results: All participants enabled to complete iTMT with <3 min, indicating high feasibility. The average iTMT time for CN-Older, PD, and MCI participants were 20.9 ± 0.9 s, 32.3 ± 2.4 s, and 40.9 ± 4.5 s, respectively. After adjusting for age and education level, pairwise comparison suggested large effect sizes for iTMT between CN-older versus PD (Cohen’s d = 1.7, p = 0.024) and CN-older versus MCI (d = 1.57, p < 0.01). Significant correlations were observed when comparing iTMT time with the gait speed (r = −0.4, p = 0.011) and MoCA score (r = −0.56, p < 0.01). Conclusion: This study demonstrated the feasibility and early results supporting the potential application of iTMT to determine cognitive-motor and distinguishing individuals with MCI and PD from CN-older adults. Future studies are warranted to test the ability of iTMT to track its subtle changes over time.

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