Visuospatial cognition in people with Parkinson's disease: a pilot study assessing a block span task using fMRI

Impaired visuospatial working memory (WM) often negatively impacts the quality of life of patients with Parkinson's Disease (PD). The Block Span Task (BST) is a novel Corsi-Block-like task adapted for use in functional magnetic resonance imaging (MRI) scanner to understand the neurophysiological mechanisms underlying visuospatial impairment in PD. This pilot study examines whether the BST is a practical tool to provide an in-scanner visuospatial WM task for older adults with mild-moderate PD.

We recruited and assessed 21 older adults with mild-moderate PD (F = 9, M = 12, age: 70 ± 8 years, Hoehn and Yahr stage: 2.31 ± 0.54), with no overt dementia for participation in the task while lying in the scanner. They abstained from their anti-Parkinsonian medications for 12 h before the assessment. In scanner, participants viewed sequences of block locations on the screen before replicating the sequences on the corresponding buttons of a response pad. Following independent component analysis, components with positive, significant beta values were identified.

Administration of the BST task in an older PD population shows feasibility. Results from the encoding phase of the task were aligned with its intended design, implicating recruitment of neural networks with justifiable visuospatial WM involvement. The encoding phase of the task implicated recruitment of the superior temporal gyrus, superior medial frontal gyrus, precuneus, and posterior cingulate cortex, including auditory, cognitive, and default-mode networks.

This pilot study provides initial evidence that impaired patients with PD can complete the BST fMRI task. Further, the BST appeared to engage significant neural regions that were consistent with an encoding condition in this population. Despite having a small sample size, these preliminary findings support that BST may be useful in future examination of visuo-spatial skills and the underlying brain mechanisms in patients with PD. Future works will be needed to replicate and refine these coarse and preliminary observations, and explore the degree of functional alterations in the recruited networks, when compared to healthy individuals.