Evaluation of Block Span Task as fMRI-compatible assessment of visuospatial cognition for people with Parkinson’s disease Público

Zhang, Emily (Spring 2024)

Permanent URL: https://etd.library.emory.edu/concern/etds/w3763837g?locale=pt-BR
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Abstract

Background: Impairments in cognitive processes such as visuospatial working memory are thought to significantly impair function and quality of life in individuals with Parkinson’s Disease (PD) but understanding and treating of the motor symptoms has been more successful than for cognitive symptoms. A popular and validated tool to assess visuospatial working memory in both clinical and experimental contexts is the Corsi Block- Tapping task. The Corsi task traditionally requires the use of a physical board and must be administered with the examiner and subject face-to-face. However, neuroimaging has been especially valuable for its potential in revealing the underlying mechanisms and identifying the key biomarkers of motor symptoms and cognitive decline in PD. Adapting an established visuospatial assessment task to be compatible with simultaneous neuroimaging would allow studies to take advantage of the preexisting body of research on that task. The Block Span Task (BST) is a Corsi-like task adapted for use in an fMRI scanner.

Research Question: Does the BST allow for the integration of functional imaging with a valid assessment of visuospatial cognition in adults with PD? 

Methods: 21 older adults with mild-moderate PD and no overt dementia were asked to abstain from taking their anti-Parkinsonian medications for 12 hours. The subjects completed the BST during functional magnetic resonance imaging. The BST required subjects to view a spatial arrangement of blocks which were individually illuminated in a 4-block sequence. Subjects replicated the sequence with corresponding fingers on a response pad. Imaging data was analyzed for the significance of modulation by each phase on different brain regions.

Results: Different phases of the task demonstrated modulation of unique regions appropriate for the activity associated with that phase. In particular, the BST allowed for valuable assessment of regions’ involvement in the encoding phase of visuospatial working memory.

Conclusions: The BST warrants further refinement but demonstrates potential as a valid tool for the study of the neural processes underlying visuospatial. The BST may be valuable in understanding the mechanisms underlying visuospatial disfunction in PD.

Table of Contents

Background/Introduction 1

Cardinal Features and Prevalence of PD 1

Pathophysiology of PD 1

Visuospatial Working Memory 2

Impairment of Visuospatial Cognition in PD 2

Neuroimaging in PD 3

The Corsi Block- Tapping Task 5

Adapting the Corsi Task for fMRI 5

The Block Span Task 6

Hypothesis/ Research Question 7

Methods 7

Participants 7

Inclusion and Exclusion Criteria 7

Assessments 8

Block Span Task Description and Protocol 12

Training Participants on the BST 12

Administration of the BST 13

Image Acquisition 14

Image Pre-Processing 16

Analysis 17

Participant Characteristics 17

Task Performance 17

Imaging Data 17

Imaging analysis 1: Contrast for each regressor against rest 19

Imaging analysis 2: Corsi Motor minus Random Motor 19

Imaging analysis 3: Corsi Visual minus Random Motor 19

Results 20

Participant Clinical Characteristics 20

Tremor and Hand Usage 21

Block Span Task Performance 22

Performance on Other Neuropsychological Assessments 25

Imaging analysis 1: Contrast for each regressor against rest 27

Imaging analysis 2: Corsi Motor minus Random Motor 33

Imaging Analysis 3: Corsi Visual minus Random Motor 33

Discussion 35

Performance on Block Span Task 35

In the Context of Span Achieved on Other Tasks 35

In the Context of Performance on Other Tasks 36

In the Context of Motor Differences 37

General Considerations Regarding BST Performance 38

Imaging Analysis 1: BST Conditions vs Rest 39

Random Motor vs Rest 43

Corsi Visual vs Rest 44

Imaging Analysis 2: Corsi Motor - Random Motor 46

Imaging Analysis 3: Corsi Visual - Random Motor 47

Imaging Analysis: Regions of Other Interest 50

Doucet et al. (2013) 50

PD-Related Regions 50

Conclusion 52

References 54

 

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