Visual spatial cognition in neurodegenerative disease

Katherine L Possin, Katherine L Possin

Abstract

Visual spatial impairment is often an early symptom of neurodegenerative disease; however, this multi-faceted domain of cognition is not well-assessed by most typical dementia evaluations. Neurodegenerative diseases cause circumscribed atrophy in distinct neural networks, and accordingly, they impact visual spatial cognition in different and characteristic ways. Anatomically-focused visual spatial assessment can assist the clinician in making an early and accurate diagnosis. This article will review the literature on visual spatial cognition in neurodegenerative disease clinical syndromes, and where research is available, by neuropathologic diagnoses. Visual spatial cognition will be organized primarily according to the following schemes: bottom-up/top-down processing, dorsal/ventral stream processing, and egocentric/allocentric frames of reference.

Figures

Figure 1
Figure 1
As visual information travels from primary visual cortex (V1) through secondary and tertiary processing areas (V2-V5), increasingly more complex aspects of visual experience are processed and cells are tuned to larger receptive fields. Color and form information is processed by a ventral pathway via V2, V4, and inferior temporal cortex. Location and motion information is processed by a dorsal pathway via dorsal V2 and V3, V5, and posterior parietal cortex.
Figure 2
Figure 2
A screen shot from an allocentric virtual navigation task we are using in our laboratory that is based on the Morris Water Maze. Subjects are virtually placed in a new starting position on each trial and navigate through the circular field to find a hidden treasure. The subjects must develop a cognitive map of the treasure's position relative to the distal cues to find the treasure because the route changes on each trial.
Figure 3
Figure 3
Navon figures. Patients with impaired global processing will identify the smaller letters but will fail to identify the global letters (i.e., in this example, they would report seeing only an E in the first figure and an A in the second figure).

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