Path Integration Changes as a Cognitive Marker for Vascular Cognitive Impairment?—A Pilot Study

Abstract

Path integration spatial navigation processes are emerging as promising cognitive markers for prodromal and clinical Alzheimer's disease (AD). However, such path integration changes have been less explored in Vascular Cognitive Impairment (VCI), despite neurovascular change being a major contributing factor to dementia and potentially AD. In particular, the sensitivity and specificity of path integration impairments in VCI compared to AD is unclear. In the current pilot study, we explore path integration performance in early-stage AD and VCI patient groups and hypothesize that: (i) medial parietal mediated egocentric processes will be more affected in VCI; and (ii) medial temporal mediated allocentric processes will be more affected in AD. This cross-sectional study included early-stage VCI patients (n = 9), AD patients (n = 10) and healthy age-matched controls (n = 20). All participants underwent extensive neuropsychological testing, as well as spatial navigation testing. The spatial navigation tests included the virtual reality "Supermarket" task assessing egocentric (body-based) and allocentric (map-based) navigation as well as the "Clock Orientation" test assessing egocentric and path integration processes. Results showed that egocentric integration processes are only impaired in VCI, potentially distinguishing it from AD. However, in contrast to our prediction, allocentric integration was not more impaired in AD compared to VCI. These preliminary findings suggest limited specificity of allocentric integration deficits between VCI and AD. By contrast, egocentric path integration deficits emerge as more specific to VCI, potentially allowing for more specific diagnostic and treatment outcome measures for vascular impairment in dementia.

Ecological meanings: A consensus paper on individual differences and contextual influences in embodied language

“…For instance, AD and its prodromal stages affect the allocentric frames of reference (Serino, Cipresso, Morganti, & Riva, 2014;Tuena et al, 2021). Conversely, PD, dementia with Lewy bodies, and vascular dementia impact egocentric processing (Humphries et al, 2016;Lowry, Puthusseryppady, Coughlan, Jeffs, & Hornberger, 2020;Nedelska et al, 2017;Thurm et al, 2016). In addition, as some neurodegenerative diseases, such as frontotemporal dementias, parkinsonisms, and AD, lead to differences in naming of manipulable and non-manipulable objects (e.g., Cotelli et al, 2006), it could be interesting to investigate linguistic affordances in these populations.…”

Building Embodied Spaces for Spatial Memory Neurorehabilitation with Virtual Reality in Normal and Pathological Aging

“…Navigational strategies (e.g., path integration, landmark-based, imagery) for determining orientation and locations rely on the successful use of at least one of these elements [3]. Indeed, spatial cognition frames of reference (i.e., body-centered representations, namely egocentric frame; world-centered representations, namely allocentric frame) that support successful spatial navigation and memory have been shown to decline in normal aging and neurodegenerative diseases [4][5][6][7][8][9]. Simultaneously with these impairments, the elderly face a decline in idiothetic and sensory processing that accounts for spatial navigation deficits in normal aging and neurodegenerative diseases [10].…”

Spatial Disorientation in Alzheimer's Disease: The Missing Path From Virtual Reality to Real World

“…Several studies, including 11 using non-immersive and 2 using immersive VR, have reported AD patients to be impaired in egocentric and allocentric navigation, associated with pathology related changes to the medial temporal and parietal lobes (Hort et al, 2007;Jheng and Pai, 2009;Pengas et al, 2010;Nedelska et al, 2012;Vlcek and Laczo, 2014;Tu et al, 2015;Allison et al, 2016;Howett et al, 2019;Lowry et al, 2020). Some studies have additionally looked at the interaction between both navigation strategies.…”