Visuospatial Function in Parkinson's Disease

帕金森病(PD)是一种常见的与年龄相关的神经退行性疾病，涉及多方面 视觉空间认知功能受损。空间功能障碍是由高血压病患者的病理改变引起的 大脑的关联区，也有来自低级视觉处理区域的缺陷输入。 视力缺陷在帕金森病患者中很普遍，但实际上对视力和 认知和日常功能在这种障碍中。同样未知的是首字母侧的认知后遗症 运动障碍，尽管帕金森病几乎总是单侧起病的神经变性和明确 将空间异常与右脑功能障碍联系起来的证据。我们提出了一种多层次的方法来 检查帕金森病患者的视觉空间功能障碍。一个主要的焦点是视觉的视觉空间结果 缺陷，特别是由于对比敏感度降低而导致的信号强度降低。创新的 研究的一个方面是我们使用倍频技术和光学相干断层扫描来评估 视觉(包括视网膜)功能。第二个焦点是出现运动障碍的一侧，对侧。 O以基底节功能障碍为主的大脑半球。我们计划对马达进行控制测试- 系统和前额叶功能以确定枕顶区的独立程度 影响帕金森病的空间功能。此外，我们还将对视觉与视觉的关系进行探讨 日常功能的视觉空间障碍，通过自我报告问卷和 目的进行步态曲率的开放式测量。评估将在基线和一年的随访期进行。 我们建议对36例左发性帕金森病(LPD)、36例右发性帕金森病(RPD)患者的能力进行检测。 36名年龄匹配的健康成年人和36名健康的年轻人进行视力和视觉空间测试 功能。帕金森病患者在大多数视觉和视觉空间测试中表现较差 与年龄匹配的成年人相比，后者表现出比年轻人更差的表现。我们进一步 预计LPD将表现出比RPD更广泛的视觉空间障碍，并且 减损将区分这两个子组。我们的测试针对的是报告的视觉和视觉空间症状 由患者自己进行，确保机制的阐明将具有临床意义。 在LPD和RPD中展示不同的性能概况将支持选择性的论点 帕金森病的视觉空间缺陷，并建议差异化的视觉、认知和功能增强策略。

Parkinson's disease (PD) is a common age-related neurodegenerative disorder in which multiple aspects of visuospatial cognitive function are impaired. Spatial dysfunction arises from pathological changes in high- order association areas of the brain but also from defective input from lower-level visual processingareas. Deficits in vision are prevalent in PD but virtually nothing is known about the relation between vision, cognition, and daily function in this disorder. Also unknown are the cognitive sequelae of the side of initial motor impairment, despite PD nearly always having unilateral onset of neurodegeneration and unequivocal evidence linking spatial abnormalities to right-hemisphere dysfunction. We propose a multi-level approach to examining visuospatial dysfunction in PD. One major focus is on the visuospatial consequencesof visual deficits, specifically the reduced signal strength that results from contrast sensitivity loss. An innovative aspect of the study is our use of frequency doubling technology and optical coherence tomographyto assess visual (including retinal) function. A second focus is on the side of onset of motor impairment, contralateral o the hemisphere with predominant basal ganglia dysfunction. We plan to conduct control tests of motor- system and prefrontal function to ascertain the extent of independence of the occipital and parietal areas in affecting spatial function in PD. Further, we will conduct an exploration of the relation of visual and visuospatial impairments to daily function as assessed through self-report questionnaires and with an objective open-field measure of gait curvature. Assessmentwill occur at baseline and at one-year follow-up. We propose to examine the ability of 36 patients with left-onset PD (LPD), 36 with right-onset PD (RPD), 36 healthy age-matched adults, and 36 healthy young adults to perform on tests of vision and visuospatial function. Individuals with PD will likely exhibit poorer performance on most tests of vision and visuospatial function than age-matched adults, who in turn will exhibit poorer performance than young adults. We further expect that LPD will show more extensive visuospatial impairments than RPD, and that the pattern of impairments will distinguish the two subgroups. Our tests target visual and visuospatial symptoms reported by the patients themselves, ensuring that the elucidation of mechanisms will have clinical relevance. Demonstration of different profiles of performance in LPD and RPD would bolster arguments of selective visuospatial deficits in PD and suggest differential visual, cognitive, and functional enhancement strategies.