The clinical approach to the identification of higher-order visual dysfunction in neurodegenerative disease

Pelak, Victoria S.

doi:10.1007/s11910-022-01186-7

Cited by 7 publications

(4 citation statements)

References 31 publications

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“…Unauthorized reproduction of this article is prohibited PCA is a rare, progressive, neurodegenerative syndrome that affects the posterior cortices resulting in visual dysfunction early in the disease 9 . The disease process may initially affect parietal, occipital or occipita-temporal regions therefore patients can present with a wide range of visual symptoms affecting higher-order visual function, while sparing anterograde memory, language, executive functions and personality 10,11 . PCA typically presents in the fifth and sixth decade of life, and as the disease progresses patients develop dysfunction of other cognitive domains.…”

Section: Discussionmentioning

confidence: 99%

“…9 The disease process may initially affect parietal, occipital, or occipitatemporal regions; therefore, patients can present with a wide range of visual symptoms affecting higher order visual function while sparing anterograde memory, language, executive functions, and personality. 10,11 PCA typically presents in the fifth and sixth decades of life, and as the disease progresses, patients develop dysfunction of other cognitive domains. The most common etiology of PCA syndrome is Alzheimer disease pathology; however, it can also be seen with other underlying pathologies such as dementia with Lewy body, corticobasal degeneration, prion disease, and subcortical gliosis.…”

Section: Discussionmentioning

confidence: 99%

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Clinical Reasoning: An 80-Year-Old Woman With a Homonymous Hemianopsia

2022

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An 80-year-old woman who was experiencing visual symptoms for two years was found to have a left homonymous hemianopsia. On further evaluation the following month, she was noted to have simultanagnosia and alexia. Magnetic resonance imaging (MRI) of the brain did not reveal a structural etiology for the symptoms. [18 30 F]-fluorodeoxyglucose positron emission tomography-computed tomography (PET-CT) was performed to aid in the diagnostic investigation. This case highlights the differential diagnosis of a homonymous hemianopsia in the absence of a structural lesion on MRI and the role of PET-CT imaging in such patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinical Reasoning: An 80-Year-Old Woman With a Homonymous Hemianopsia

2022

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“…Furthermore, higher-order visual functions (i.e., cognitive operations with visual information) also appear defective, with reduced visual identification and visuospatial processing [157,158]. Additionally, AD patients may experience visual and somatic (e.g., olfactory, tactile) hallucinations, especially at the advanced stages of the disease [159].…”

Section: Signs Of Visual Dysfunction In Alzheimer's Diseasementioning

confidence: 99%

Retinal Alterations Predict Early Prodromal Signs of Neurodegenerative Disease

Casciano,

Zauli,

Celeghini

et al. 2024

IJMS

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Neurodegenerative diseases are an increasingly common group of diseases that occur late in life with a significant impact on personal, family, and economic life. Among these, Alzheimer’s disease (AD) and Parkinson’s disease (PD) are the major disorders that lead to mild to severe cognitive and physical impairment and dementia. Interestingly, those diseases may show onset of prodromal symptoms early after middle age. Commonly, the evaluation of these neurodegenerative diseases is based on the detection of biomarkers, where functional and structural magnetic resonance imaging (MRI) have shown a central role in revealing early or prodromal phases, although it can be expensive, time-consuming, and not always available. The aforementioned diseases have a common impact on the visual system due to the pathophysiological mechanisms shared between the eye and the brain. In Parkinson’s disease, α-synuclein deposition in the retinal cells, as well as in dopaminergic neurons of the substantia nigra, alters the visual cortex and retinal function, resulting in modifications to the visual field. Similarly, the visual cortex is modified by the neurofibrillary tangles and neuritic amyloid β plaques typically seen in the Alzheimer’s disease brain, and this may reflect the accumulation of these biomarkers in the retina during the early stages of the disease, as seen in postmortem retinas of AD patients. In this light, the ophthalmic evaluation of retinal neurodegeneration could become a cost-effective method for the early diagnosis of those diseases, overcoming the limitations of functional and structural imaging of the deep brain. This analysis is commonly used in ophthalmic practice, and interest in it has risen in recent years. This review will discuss the relationship between Alzheimer’s disease and Parkinson’s disease with retinal degeneration, highlighting how retinal analysis may represent a noninvasive and straightforward method for the early diagnosis of these neurodegenerative diseases.

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“…The retina is an embryologic offshoot of the brain, sharing similar vascular patterns and vascular regulatory mechanisms 23 . Complex visual information from the environment is encoded by the retina and decoded, processed, and interpreted by the thalamus and visual cortex to form a representation of objects and faces and provide visuospatial and visuomotor cues for action 24 [e6]. The peripheral function of the eye is assessed through multi‐dimensional aspects of vision like visual acuity, contrast sensitivity, color discrimination, and visual field.…”

Section: The Connection Between the Senses And The Brainmentioning

confidence: 99%

Are cognitive researchers ignoring their senses? The problem of sensory deficit in cognitive aging research

Abraham

Hong

Deal

et al. 2023

J American Geriatrics Society

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Sensory impairments are common in older adult populations and have notable impacts on aging outcomes. Relationships between sensory and cognitive functions have been clearly established, though the mechanisms underlying those relationships are not fully understood. Given the growing burden of dementia, older adults with sensory deficits are an important and growing population to study in cognitive aging research. Yet, cognitive research sometimes excludes those with uncorrected significant/severe sensory deficits and often poorly or inconsistently assesses those deficits. Observational and interventional studies that exclude participants with sensory deficits will be limited in their generalizability to the narrower subset of the older adult population without vision or hearing impairment and may be missing an opportunity to study a growing population of older adults at higher risk of cognitive impairment. Strategies exist for adapting cognitive testing instruments, and inroads could be made into collecting normative data to inform ongoing research. Bringing together psychometricians with researchers who specialize in vision and hearing impairments could launch highly innovative research on both measurement methods and cognitive disease etiology, as sensory organs provide readily accessible neuronal and vascular beds that may show pathology earlier and elucidate innovative screening opportunities for early signs of cognitive disease.

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The clinical approach to the identification of higher-order visual dysfunction in neurodegenerative disease

Cited by 7 publications

References 31 publications

Clinical Reasoning: An 80-Year-Old Woman With a Homonymous Hemianopsia

Clinical Reasoning: An 80-Year-Old Woman With a Homonymous Hemianopsia

Retinal Alterations Predict Early Prodromal Signs of Neurodegenerative Disease

Are cognitive researchers ignoring their senses? The problem of sensory deficit in cognitive aging research

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