Visual correlates of functional difficulties in Parkinson's disease and Alzheimer's disease
Laudate, Thomas M.
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Although motor dysfunction in Parkinson's disease (PD) and memory deficits in Alzheimer's disease (AD) are the respective hallmark symptoms, both neurodegenerative disorders are also associated with significant disruptions in visual functioning. In PD, visuospatial function is impaired, particularly in patients with left-side onset of motor symptoms (LPD), reflecting pathology in right hemisphere brain regions, including the parietal lobe. LPD visuospatial performance is characterized by perceptual distortions, suggesting that lower-level visual processing may contribute to abnormal performance. In AD and PD, reduced contrast sensitivity and other visual difficulties have the potential to impact everyday functioning. The relation of PD visuospatial problems, and AD and PD contrast sensitivity deficits to higher-order impairments is understudied. The present experiments examined visual and visuospatial difficulties in these groups and evaluated an intervention to improve everyday visual function. Experiment I assessed performance on a line bisection task in PD. Participants included non-demented patients (10 LPD, 10 with right-side motor onset [RPD]) and 11 normal control adults (NC). Performance was related to data from measures of retinal structure (Optical Coherence Tomography) and function (Frequency Doubling Technology; FDT) across the eye. Correlations of structure and function were found for all groups. LPD showed predicted downward bisection bias in some sections of the left visual field. Expected rightward bisection bias in LPD was not consistently seen using this presentation method. For RPD, in some sectors, worse FDT sensitivity correlated with upward line bisection bias, as predicted. Experiment II investigated if performance of a complex, familiar visual search task (bingo) could be enhanced in AD and PD by manipulating the visual components of contrast, size, and visual complexity of task stimuli. Participants were 19 younger adults, 14 AD, 17 PD, and 33 NC. Increased stimulus size and decreased complexity improved performance for all groups. Increasing contrast also benefited the AD patients, presumably by compensating for their contrast sensitivity deficit, which was more severe than in the PD and NC groups. The general finding of improved performance across healthy and afflicted groups suggests the value of visual support as an easy-to-apply intervention to enhance cognitive performance.
Thesis (Ph.D.)--Boston University
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