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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
INMH_2014_poster.pdf (PDF, 676.26 KB)
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