Patients with Parkinson’s Disease Show Alteration in their Visuospatial Abilities and in their Egocentric and Allocentric Spatial Orientation Measured by Card Placing Tests

Abstract

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.

Cognitive and language deficits in persons with Parkinson's disease

“…Demencija se uglavnom javlja kod pacijenata sa uznapredovalom kliničkom slikom i nije karakteristična za rane faze PB (Vuković, 2016(Vuković, , 2019a. Karakteriše se poremećajima u različitim kognitivnim domenima: EF, vizuospacijalnim sposobnostima, pamćenju, jeziku, pažnji, kao i bihevioralnim smetnjama (Emre, 2003;Kudlicka et al, 2018;Vuković, 2016). Procenjuje se da se demencija javlja kod oko 40% osoba sa PB, te da je incidenca šest puta veća u odnosu na zdravu populaciju (Emre, 2003).…”

“…Budući da EF obuhvataju različite kognitivne komponente, poremećaji mogu da se ispolje brojnim disegzekutivnim simptomima. Utvrđeni su deficiti u domenima kontrolisanja pažnje, promene seta, planiranja, inhibitorne kontrole, formiranju koncepata, donošenja odluka i smetnjama na zadacima socijalne kognicije (Dirnberger & Jahanshahi, 2013;Emre, 2003). Smatra se da ove smetnje u velikoj meri utiču na kvalitet života obolelih osoba (Kudlicka et al, 2018).…”

“…Takođe je pokazano prisustvo deficita u oblasti spacijalnih sposobnosti, pre svega vizuospacijalnih veština i orijentacije u prostoru, a zatim orijentacije prema sebi (Fernandez-Baizan et al, 2020). Konstrukciona apraksija, smetnje vizuelnog opažanja i vizuelnog rezonovanja karakterišu poremećaj vizuospacijalnih veština kod PB (Vuković, 2016).…”

“…Međutim, sposobnost prepoznavanja je očuvanija u poređenju s prisećanjem. S napredovanjem bolesti deficiti pamćenja postaju izraženiji (Emre, 2003;Whittington et al, 2006). U poređenju s osobama sa Alchajmerovom bolešću, osobe sa PB imaju značajno očuvaniju sposobnost pamćenja, ali zato ispoljavaju lošiju pažnju, lošije EF i vizuospacijalne sposobnosti (Brønnick, 2015).…”

A modified version of the interlocking finger test as a bedside screening test for visuospatial deficits and dementia in Parkinson's disease

“…The prevalence of mild cognitive impairment in PD is 40% (Baiano et al., 2020 ) and the prevalence of dementia in PD is 24–31% (Aarsland et al., 2005 ). Besides executive dysfunctions and impairments in memory and attention, PD patients often show visuospatial deficits (Aarsland et al., 2010 ; Curtis et al., 2019 ; Fernandez‐Baizan et al., 2020 ; Muslimovic et al., 2005 ) including impairments in visuospatial perception, orientation, or construction. Deficits in visuospatial abilities increase in the course of the disease (Muslimović et al., 2007 ) and initially more severe impairments are predictive for the progression of cognitive impairment in PD (Stepkina et al., 2010 ).…”