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

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

BMC Neurology ◽

10.1186/s12883-021-02366-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Shoji Kawashima ◽

Yoko Shimizu ◽

Yoshino Ueki ◽

Noriyuki Matsukawa

Keyword(s):

Parkinson’S Disease ◽

Working Memory ◽

Parkinson's Disease ◽

Cognitive Impairment ◽

Correct Answer ◽

Brain Regions ◽

Middle Frontal Gyrus ◽

Common Symptom ◽

Visuospatial Working Memory ◽

Parietal Lobule

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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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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The Neural Correlates of Spatial and Object Working Memory in Elderly and Parkinson’s Disease Subjects

Behavioural Neurology ◽

10.1155/2015/123636 ◽

2015 ◽

Vol 2015 ◽

pp. 1-10 ◽

Cited By ~ 6

Author(s):

Silvia P. Caminiti ◽

Chiara Siri ◽

Lucia Guidi ◽

Angelo Antonini ◽

Daniela Perani

Keyword(s):

Parkinson’S Disease ◽

Working Memory ◽

Parkinson's Disease ◽

Neural Correlates ◽

Elderly Subjects ◽

Task Execution ◽

Compensatory Mechanisms ◽

Frontoparietal Network ◽

Fmri Study ◽

Comparable Performance

This fMRI study deals with the neural correlates of spatial and objects working memory (SWM and OWM) in elderly subjects (ESs) and idiopathic Parkinson’s disease (IPD). Normal aging and IPD can be associated with a WM decline. In IPD population, some studies reported similar SWM and OWM deficits; others reported a greater SWM than OWM impairment. In the present fMRI research, we investigated whether compensated IPD patients and elderly subjects with comparable performance during the execution of SWM and OWM tasks would present differences in WM-related brain activations. We found that the two groups recruited a prevalent left frontoparietal network when performing the SWM task and a bilateral network during OWM task execution. More specifically, the ESs showed bilateral frontal and subcortical activations in SWM, at difference with the IPD patients who showed a strict left lateralized network, consistent with frontostriatal degeneration in IPD. The overall brain activation in the IPD group was more extended as number of voxels with respect to ESs, suggesting underlying compensatory mechanisms. In conclusion, notwithstanding comparable WM performance, the two groups showed consistencies and differences in the WM activated networks. The latter underline the compensatory processes of normal typical and pathological aging.

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

Aging Neuropsychology and Cognition ◽

10.1080/13825585.2020.1828804 ◽

2020 ◽

pp. 1-17

Author(s):

Ece Bayram ◽

Irene Litvan ◽

Brenton A. Wright ◽

Cailey Grembowski ◽

Qian Shen ◽

...

Keyword(s):

Parkinson’S Disease ◽

Working Memory ◽

Parkinson's Disease ◽

Memory Load ◽

Visuospatial Working Memory ◽

Cognitively Normal

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Visuospatial working memory in Parkinson's disease.

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp.52.11.1228 ◽

1989 ◽

Vol 52 (11) ◽

pp. 1228-1235 ◽

Cited By ~ 90

Author(s):

V A Bradley ◽

J L Welch ◽

D J Dick

Keyword(s):

Parkinson’S Disease ◽

Working Memory ◽

Parkinson's Disease ◽

Visuospatial Working Memory

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Brain Impairment revealed by Multi-Modality MRI in Parkinson’s Disease

10.1101/2020.06.22.20136663 ◽

2020 ◽

Author(s):

Zhang Ran ◽

Gong Ping ◽

Ge Haitao

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Early Detection ◽

Brain Regions ◽

Precentral Gyrus ◽

Functional Changes ◽

Lingual Gyrus ◽

Postcentral Gyrus ◽

Normal Ageing ◽

Abnormal Brain

AbstractObjectiveTo study the abnormal brain regions of patients with Parkinson’s disease (PD) using multimodality MRI to provide complementary information for early detection for PD.Methods27 patients with early PD and 25 normal ageing volunteers were included in the study. Multimodality MRI data were acquired and processed to extract neuroimaging features to test the structural and functional changes using a two-sample t-test.ResultsThe changes of brain regions were disagreed for different modality MRI data between PD and normal ageing individuals. Nevertheless,the postcentral gyrus, precentral gyrus, lingual gyrus and paracentral lobule were significantly different for all three modalities.ConclusionMultimodality MRI data can reflect the structural and functional changes of PD, and reveal the hidden information which is of great significance to assist early detection for PD.

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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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Impairment of the spatial working memory in Parkinson's disease with MCI: A fMRI study using n back task

Journal of the Neurological Sciences ◽

10.1016/j.jns.2017.08.1025 ◽

2017 ◽

Vol 381 ◽

pp. 361

Author(s):

S. Kawashima ◽

Y. Shimizu ◽

Y. Ueki ◽

N. Matsukawa

Keyword(s):

Parkinson’S Disease ◽

Working Memory ◽

Parkinson's Disease ◽

Spatial Working Memory ◽

Fmri Study ◽

Back Task

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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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