THE ROLE OF VISUOSPATIAL AND VISUOMOTOR FUNCTIONS IN THE DIAGNOSIS OF ALZHEIMER’S DISEASE
Berente-Kerestély Dalida Borbála
János Szentágothai Neurosciences
Dr. Bereczki Dániel
Semmelweis Egyetem Neurológiai Klinika Tanterme
2024-09-16 14:00:00
Clinical Neurological Research
Dr. Kovács Tibor
Dr. Horváth András Attila
Dr. Kovács Tibor
Dr. Zádori Dénes
Dr. Bereczki Dániel
Dr. Dóra Dávid
Dr. Makkos Zoltán
Alzheimer’s disease (AD) is the principal cause of major neurodegenerative disorders in older adults, and it poses a tremendous socioeconomic burden on society. To this day, AD is incurable. The earlier the diagnosis is established the better, however, adequate screening methods are yet to be developed. Previous studies pointed to the impairment of visuospatial and visuomotor functions in AD, which could have screening potential contributing to timely diagnosis. We examined AD patients and healthy controls with an extensive neuropsychological test battery. We found that visuospatial subscore of the Addenbrooke’s Cognitive Examination (ACE) was impaired already in the early phase of the disease. Furthermore, it showed a linear trajectory of decline over the disease course, which pointed to its potential in the diagnosis and follow-up of patients. Since intervention has better outcomes if started already in mild cognitive impairment (MCI), the prodromal phase of AD, we investigated healthy controls and patients with multiple domain amnestic MCI with detailed neuropsychological examination and structural and functional MRI acquisition. We found reduced cortical thickness of the left temporal pole and right superior temporal gyrus in MCI. Furthermore, upon analysing the visuospatial network with functional MRI, we found decreased functional connectivity between left and right frontal areas, whereas functional connectivity was increased between left frontotemporal regions. To assess the diagnostic potential of visuospatial and visuomotor functions, we applied the Trail-making test based computerized Precognize paradigm MCI patients and healthy controls. Upon analysing the computer mouse movement characteristics of the two groups derived from Precognize, we found impaired fine motor control in the MCI group. From the movement characteristics, entropy of hand movements showed the highest discriminative potential between cognitively healthy older adults and MCI patients. Based on our results, visuospatial and visuomotor abilities are impaired already in the MCI stage of the AD continuum. The Precognize paradigm pointed to the promising potential of fine movement analysis in the development of a population-wide automated screening tool for cognitive impairment in older adults.
