Assessing mild cognitive impairment using object-location memory in immersive virtual environments

被引:15
作者
Castegnaro, Andrea [1 ]
Howett, David [2 ]
Li, Adrienne [3 ]
Harding, Elizabeth [1 ]
Chan, Dennis [1 ]
Burgess, Neil [1 ]
King, John [4 ]
机构
[1] UCL, Inst Cognit Neurosci, London, England
[2] Univ Bristol, Sch Psychol Sci, Bristol, Avon, England
[3] York Univ, Dept Psychol, Toronto, ON, Canada
[4] UCL, Dept Clin Educ & Hlth Psychol, London, England
基金
英国惠康基金;
关键词
Alzheimer's disease; entorhinal cortex; spatial cognition; virtual reality; LATERAL ENTORHINAL CORTEX; MEDIAL TEMPORAL-LOBE; ALZHEIMERS-DISEASE; SPATIAL NAVIGATION; RECOGNITION MEMORY; TAU PATHOLOGY; FUNCTIONAL DISCONNECTION; HIPPOCAMPAL SYSTEMS; PERIRHINAL CORTEX; ACTIVITY PATTERNS;
D O I
10.1002/hipo.23458
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
Pathological changes in the medial temporal lobe (MTL) are found in the early stages of Alzheimer's disease (AD) and aging. The earliest pathological accumulation of tau colocalizes with the areas of the MTL involved in object processing as part of a wider anterolateral network. Here, we sought to assess the diagnostic potential of memory for object locations in iVR environments in individuals at high risk of AD dementia (amnestic mild cognitive impairment [aMCI] n = 23) as compared to age-related cognitive decline. Consistent with our primary hypothesis that early AD would be associated with impaired object location, aMCI patients exhibited impaired spatial feature binding. Compared to both older (n = 24) and younger (n = 53) controls, aMCI patients, recalled object locations with significantly less accuracy (p < .001), with a trend toward an impaired identification of the object's correct context (p = .05). Importantly, these findings were not explained by deficits in object recognition (p = .6). These deficits differentiated aMCI from controls with greater accuracy (AUC = 0.89) than the standard neuropsychological tests. Within the aMCI group, 16 had CSF biomarkers indicative of their likely AD status (MCI+ n = 9 vs. MCI- n = 7). MCI+ showed lower accuracy in the object-context association than MCI- (p = .03) suggesting a selective deficit in object-context binding postulated to be associated with anterior-temporal areas. MRI volumetric analysis across healthy older participants and aMCI revealed that test performance positively correlates with lateral entorhinal cortex volumes (p < .05) and hippocampus volumes (p < .01), consistent with their hypothesized role in binding contextual and spatial information with object identity. Our results indicate that tests relying on the anterolateral object processing stream, and in particular requiring successful binding of an object with spatial information, may aid detection of pre-dementia AD due to the underlying early spread of tau pathology.
引用
收藏
页码:660 / 678
页数:19
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