An Adaptive Measure of Visuospatial Impairment in Dementia with Lewy Bodies

Phillips, Joseph R.; Matar, Elie; Martens, Kaylena A. Ehgoetz; Moustafa, Ahmed A.; Halliday, Glenda M.; Lewis, Simon J.G.

doi:10.1002/mdc3.13488

Cited by 3 publications

(6 citation statements)

References 57 publications

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“…We would propose that the currently proposed research criteria for MCI-LB should specify that the combination of clinically reported RBD (one core feature) that is confirmed by RSWA (one objective biomarker) in patients with MCI should be insufficient to meet a diagnosis of probable prodromal DLB. Previous studies have found utility of the SART, MR and BPP in detecting DLB core symptoms [ 43 , 44 , 46 ]; findings are less clear for patients in the prodromal stages of this disease. It is clear that more systematized work with larger cohorts and longitudinal assessment is required to confirm their future role.…”

Section: Discussionmentioning

confidence: 94%

“…Thus, it is possible that a larger sample size might be required to further evaluate this potential relationship. Previous findings have suggested that the MR task is reliant on visuospatial ability in DLB patients [ 44 ], which might suggest that visuospatial impairment occurs very early in DLB, before other core features emerge. An interesting additional observation was the number of patients that had low accuracy at the 0° condition from both groups.…”

Section: Discussionmentioning

confidence: 99%

“…This condition involves a straight comparison of two relatively simple shapes, and it was surprising that six of the iRBD-CN patients did not perform this task with near-perfect accuracy (>90%). However, performance on the MR has been found to be unrelated to the level of cognitive impairment per se [ 44 ], suggesting that performance at the 0° condition may reflect a selective, sub-clinical visuospatial impairment in both groups.…”

Section: Discussionmentioning

confidence: 99%

“…Patients with iRBD underwent detailed longitudinal assessment at the ForeFront Parkinson’s Disease Research Clinic at the Brain and Mind Centre, University of Sydney. They also completed the Sustained Attention Response task (SART), which has been found to be sensitive to CF in DLB patients [ 43 ], the Mental Rotation (MR) task, a visuospatial task that has also been shown to be impaired in DLB patients [ 44 ] and the Bistable Percept Paradigm (BPP) which is sensitive to VF in PD [ 45 ] and DLB patients [ 46 ]. These three tasks were chosen for two reasons: previous studies they have shown them to be sensitive to symptoms (CF, VF and visuospatial impairment) in DLB patients.…”

Section: Introductionmentioning

confidence: 99%

“…These three tasks were chosen for two reasons: previous studies they have shown them to be sensitive to symptoms (CF, VF and visuospatial impairment) in DLB patients. These tasks also have a range of difficulty, allowing them to be sensitive to features of VF, CF and visuospatial impairment that may not otherwise be detected in a clinical assessment [ 43 , 44 , 46 ].…”

Section: Introductionmentioning

confidence: 99%

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Exploring the Sensitivity of Prodromal Dementia with Lewy Bodies Research Criteria

et al. 2022

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Dementia with Lewy bodies (DLB) is an insidious neurodegenerative disease characterised by a precipitous decline in cognition, sleep disturbances, motor impairment and psychiatric features. Recently, criteria for prodromal DLB (pDLB) including clinical features and biomarkers have been put forward to aid the classification and research of this ambiguous cohort of patients. Researchers can use these criteria to classify patients with mild cognitive impairment (MCI) with Lewy bodies (MCI-LB) as either possible (either one core clinical feature or one biomarker are present) or probable pDLB (at least two core clinical features, or one core clinical feature and at least one biomarker present). However, as isolated REM sleep behaviour disorder (iRBD) confirmed with polysomnography (PSG) can be included as both a clinical and a biomarker feature, potentially reducing the specificity of these diagnostic criteria. To address this issue, the current study classified a cohort of 47 PSG-confirmed iRBD patients as probable prodromal DLB only in the presence of an additional core feature or if there was an additional non-PSG biomarker. Thirteen iRBD patients demonstrated MCI (iRBD-MCI). In the iRBD-MCI group, one presented with parkinsonism and was thus classified as probable pDLB, whilst the remaining 12 were classified as only possible pDLB. All patients performed three tasks designed to measure attentional deficits, visual hallucinations and visuospatial impairment. Patients also attended clinical follow-ups to monitor for transition to DLB or another synucleinopathy. Findings indicated that the only patient categorised by virtue of having two core clinical features as probable pDLB transitioned over 28 months to a diagnosis of DLB. The performance of this probable pDLB patient was also ranked second-highest for their hallucinatory behaviours and had comparatively lower visuospatial accuracy. These findings highlight the need for more stringent diagnostic research criteria for pDLB, given that only one of the 13 patients who would have satisfied the current guidelines for probable pDLB transitioned to DLB after two years and was indeed the patient with two orthogonal core clinical features.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Exploring the Sensitivity of Prodromal Dementia with Lewy Bodies Research Criteria

et al. 2022

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Visual dysfunction in dementia with Lewy bodies

Devenyi,

Hamedani

2024

Curr Neurol Neurosci Rep

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Purpose of Review To review the literature on visual dysfunction in dementia with Lewy bodies (DLB), including its mechanisms and clinical implications. Recent Findings Recent studies have explored novel aspects of visual dysfunction in DLB, including visual texture agnosia, mental rotation of 3-dimensional drawn objects, and reading fragmented letters. Recent studies have shown parietal and occipital hypoperfusion correlating with impaired visuoconstruction performance. While visual dysfunction in clinically manifest DLB is well recognized, recent work has focused on prodromal or mild cognitive impairment (MCI) due to Lewy body pathology with mixed results. Advances in retinal imaging have recently led to the identification of abnormalities such as parafoveal thinning in DLB. Summary Patients with DLB experience impairment in color perception, form and object identification, space and motion perception, visuoconstruction tasks, and illusions in association with visual cortex and network dysfunction. These symptoms are associated with visual hallucinations, driving impairment, falls, and other negative outcomes.

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Topological differences and confounders of mental rotation in cervical dystonia and blepharospasm

Odorfer

Yabe

Hiew

et al. 2023

Sci Rep

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Mental rotation (mR) bases on imagination of actual movements. It remains unclear whether there is a specific pattern of mR impairment in focal dystonia. We aimed to investigate mR in patients with cervical dystonia (CD) and blepharospasm (BS) and to assess potential confounders. 23 CD patients and 23 healthy controls (HC) as well as 21 BS and 19 hemifacial spasm (HS) patients were matched for sex, age, and education level. Handedness, finger dexterity, general reaction time, and cognitive status were assessed. Disease severity was evaluated by clinical scales. During mR, photographs of body parts (head, hand, or foot) and a non-corporal object (car) were displayed at different angles rotated within their plane. Subjects were asked to judge laterality of the presented image by keystroke. Both speed and correctness were evaluated. Compared to HC, CD and HS patients performed worse in mR of hands, whereas BS group showed comparable performance. There was a significant association of prolonged mR reaction time (RT) with reduced MoCA scores and with increased RT in an unspecific reaction speed task. After exclusion of cognitively impaired patients, increased RT in the mR of hands was confined to CD group, but not HS. While the question of whether specific patterns of mR impairment reliably define a dystonic endophenotype remains elusive, our findings point to mR as a useful tool, when used carefully with control measures and tasks, which may be capable of identifying specific deficits that distinguish between subtypes of dystonia.

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An Adaptive Measure of Visuospatial Impairment in Dementia with Lewy Bodies

Cited by 3 publications

References 57 publications

Exploring the Sensitivity of Prodromal Dementia with Lewy Bodies Research Criteria

Exploring the Sensitivity of Prodromal Dementia with Lewy Bodies Research Criteria

Visual dysfunction in dementia with Lewy bodies

Topological differences and confounders of mental rotation in cervical dystonia and blepharospasm

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