O2-12-02: Effects of Dementia-Related Visual Impairment on Route Following in Posterior Cortical Atrophy and Typical Alzheimer's Disease
O2-12-02: Effects of Dementia-Related Visual Impairment on Route Following in Posterior Cortical Atrophy and Typical Alzheimer's Disease
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O2-12-02：痴呆相关视觉障碍对后皮质萎缩和典型阿尔茨海默病的路线跟踪的影响
DOI：
10.1016/j.jalz.2016.06.461
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发表时间：
2016
期刊：
影响因子：
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通讯作者：
Carton A
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作者：
Carton A
背景痴呆相关的视觉损害是阿尔茨海默病的一种常见但未被认识到的症状，并且是后皮质萎缩（PCA;一种神经退行性疾病，其部分特征在于由于顶叶和枕颞叶萎缩导致的视觉空间和视觉感知技能的下降）的主要症状。皮质视觉障碍对痴呆患者的独立性和生活质量具有多种负面影响，例如，增加福尔斯和/或在熟悉和不熟悉的环境中迷路的风险。本研究探讨了与痴呆相关的视觉障碍对PCA和典型阿尔茨海默病（tAD）中路线跟随的影响，并调查了在什么条件下可以最小化路线跟随的任何问题。一个模拟和控制的真实世界环境，要求参与者沿着封闭的走廊行走（24次试验）。这些走廊根据轮廓（直; u形; s形），动态视觉提示（存在，不存在），照明水平（低：20勒克斯;高：190勒克斯）和路线方向（向前，向后）而变化。我们的主要绩效指标是任务时间。使用无线惯性测量单元（Xsens MTw）记录骨盆和每只脚的运动，并使用航位推算分析从中提取位置。SMI眼跟踪眼镜被戴上记录固定时间和location.ResultsBoth患者组表现较差的性能相比，控制整体。随着路线复杂性的增加，相对于对照组，强调了患者组的不良表现。PCA患者表现出更复杂的路线，其次是tAD患者的最差性能。此外，两个患者组中的一个亚组的参与者在这些路线中表现出严重的空间定向障碍。PCA患者的整体固定位置低于对照组参与者，这可能是视觉障碍的结果。我们探索的性能模式和预测因素的犹豫在路线以下的步态，眼动跟踪和neuropsychological measurements.ConclusionsResults表明，不仅PCA，但也tAD患者遇到的问题，空间导航，即使在一个简单的环境中的一个封闭的路线。详细的步态和位置分析可深入了解环境和患者特征之间的复杂相互作用。
BackgroundDementia-related visual impairment is a common but under-recognised symptom of Alzheimer’s disease and is a leading symptom of Posterior Cortical Atrophy (PCA; a neurodegenerative condition characterised in part by a decline in visuospatial and visuoperceptual skills due to parietal and occipito-temporal atrophy). Corticovisual impairment has multiple negative consequences on both independence and quality of life of people with dementia, for example, increasing risks of falls and/or getting lost in both familiar and unfamiliar environments. This study explores the effect of dementia-related visual impairment on route following in PCA and typical Alzheimer’s disease (tAD) and investigates under what conditions any problems with route following can be minimised.MethodsEleven PCA patients, 10 tAD patients and 13 healthy controls visited the Pedestrian Accessibility Movement Environment Laboratory (PAMELA), a simulated and controlled real-world environment in which participants were required to walk down closed corridors (24 trials). These corridors varied according to contour (straight; u-shaped; s-shaped), dynamic visual cue (present, absent), lighting level (low: 20 lux; high: 190 lux) and route direction (forward, backward). Our primary measure of performance was task time. Movements of the pelvis and of each foot were recorded using wireless inertial measurement units (Xsens MTw), from which location was also extracted using dead-reckoning analysis. SMI eye-tracking glasses were worn to record fixation duration and location.ResultsBoth patient groups demonstrated poorer performance compared to controls overall. As route complexity increased, poor performance in patient groups was emphasised relative to controls. PCA patients exhibited the worst performance for more complex routes, followed by tAD patients. Additionally, a subgroup of participants in both patient groups demonstrated profound spatial disorientation within these routes. Overall fixation position in PCA patients was lower than that in control participants, presumably as a consequence of visual impairment. We explore patterns of performance and predictors of hesitation during route following in relation to gait, eye-tracking and neuropsychological measures.ConclusionsResults indicate that not only PCA but also tAD patients experience problems with spatial navigation even when following a closed route within a simplified environment. Detailed gait and location analysis provide insights into the complex interplay between environmental and patient characteristics.