INMH 2014 poster .pdf

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Spatial Orientation Performance
Differs Across Dementia Subtypes
Prince of Wales Clinical School

S. Tu1,2, S.Wong1,2, O. Piguet1,2, J. Hodges1,2 ,
M. Hornberger1,2
1Neuroscience

Research Australia
2ARC Centre of Excellence in Cognition and its Disorders

Background

Virtual Supermarket Task

 AD is the most common form of dementia, typically
present with marked memory deficits
 Patients with bvFTD also show memory impairment
resulting in diagnostic uncertainty with AD
 Spatial disorientation appears to be unique to AD,
but lacks sensitive diagnostic tests

Aims of the Study

*AD vs. bvFTD/SD/Control

 Develop an ecologically valid assessment of spatial
orientation for patients with dementia
 Compare spatial orientation performance in AD and
FTD
 Identify neural correlates of spatial orientation

(P < 0.05)

 ‘Total’ correct orientation based on 2 principal
directional components (front/back & left/right)
 Controls > AD on all components
 Controls > bvFTD only with ⇑ task difficulty
 Semantic FTD patients showed intact spatial
orientation

Structural Imaging * Grey matter brain changes in dementia patients compared to controls (FWE, P < 0.01)

Method






 Participants shown short videos moving
through a supermarket
 Explicitly asked to keep track of direction
 2 Sections with 7 trials each:
• (1) 7, 20s, 3 turns
• (2) 7, 40s, 5 turns

**bvFTD vs. Control

58 patients and 23 controls, matched for age & education
20 AD, 24 bvFTD, 14 SD
Cognitive assessment: ACE-R, RAVLT, RCFT, Digit Span
Assessed for spatial orientation on experimental task
High-resolution structural brain MRI analysed using voxelbased morphometry in FMRIB’s Software Library (FSL)

Neuropsychological Performance
AD

bvFTD

SD

Controls Group AD vs.
Effect bvFTD
(n = 23)

(n = 20)

(n = 24)

(n = 14)

Age (y.o)

66 (8)

65 (9.3)

65 (8)

67 (3.4)

n/s

n/s

Education (yrs)

12 (3.3)

12 (3.1)

13 (1.9)

13 (3.1)

n/s

n/s

Disease Duration (yrs)

6 (4.8)

6 (4.3)

6 (1.9)

n/a

n/s

n/s

63 (20.9)

96 (2.4)

*

*

19 (5.2)

14 (5.8)

24 (1.4)

*

*

9 (1.3)

8 (2.7)

9 (0.3)

*

*

-

54 (8.6)

*

*

 AD

 bvFTD

 SD

Neural Correlates of Spatial Orientation

ACE-R:
Total (/100) 70 (9.1) 82 (10.2)
Memory (/26) 12 (4.5)
Orientation (/10)

7 (2.1)

RAVLT:
T1-5 (/75) 25 (6.9) 36 (11.3)
30min Delay (/15)

1 (1.6)

6 (4.1)

-

11 (2.4)

*

*

Recognition (/15) 10 (2.8)

11 (2.5)

-

14 (1.3)

*

n/s

29 (5.6)

31 (2.6)

32 (3.4)

*

n/s

3 (3.5)

11 (7.8)

12 (7.3)

19 (8.2)

*

*

Forward (/16)

8 (1.9)

9 (1.6)

9 (2.6)

11 (2.3)

*

n/s

Backward (/14)

4 (1.4)

5 (1.7)

6 (2.1)

8 (2.8)

*

n/s

RCFT:
Copy (/36) 25 (7.7)
Delayed (/36)

 Retrosplenial cortex correlates with spatial
orientation performance

Digit Span:

* Indicates significance at P < 0.003

 Memory significantly impaired in AD and FTD
patients

Conclusions
1. The virtual supermarket task is a practical tool for assessing spatial orientation in dementia populations.
2. Patients with FTD show significant memory impairment, but preserved spatial orientation.
3. Spatial orientation is dependent on memory processes, but is subserved by retrosplenial regions rather than
the hippocampus.

Contact: s.tu@neura.edu.au


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