Evaluation of Block Span Task as fMRI-compatible assessment of visuospatial cognition for people with Parkinson’s disease Open Access
Zhang, Emily (Spring 2024)
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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