Elsevier

Neuropsychologia

Volume 49, Issue 1, January 2011, Pages 43-48
Neuropsychologia

Distinct neuroanatomical substrates and cognitive mechanisms of figure copy performance in Alzheimer's disease and behavioral variant frontotemporal dementia

https://doi.org/10.1016/j.neuropsychologia.2010.10.026Get rights and content

Abstract

Figure copy is the most common method of visual spatial assessment in dementia evaluations, but performance on this test may be multifactorial. We examined the neuroanatomical substrates of figure copy performance in 46 patients with Alzheimer's disease (AD) and 48 patients with the behavioral variant of Frontotemporal dementia (bvFTD). A group of 94 neurologically healthy controls were studied for comparison. In AD, poor figure copy correlated significantly with right parietal cortex volumes but not with right dorsolateral prefrontal cortex volumes, whereas in bvFTD, figure copy performance correlated significantly with right dorsolateral prefrontal cortex volumes and there was only a trend with right parietal cortex volumes. The cognitive processes associated with figure copy performance also differed by diagnostic group such that figure copy was associated with spatial perception and attention in AD and with spatial planning and working memory in bvFTD. Spatial planning accounted for unique variance in the figure copy performance of bvFTD even after accounting for spatial perception, attention, and working memory. These results suggest that figure copy performance in AD and bvFTD is not anatomically specific and is differentially impacted by bottom-up and top-down aspects of visual spatial processing. Alternative methods of visual spatial assessment for dementia evaluations are proposed.

Research highlights

▶ Figure copy performance in neurodegenerative disease is multifactorial. ▶ In Alzheimer's disease, figure copy is associated with right parietal cortex volumes and spatial perception and attention. ▶ In the behavioral variant of Frontotemporal dementia, figure copy is associated with right dorsolateral prefrontal cortex volumes and spatial planning and working memory.

Section snippets

Subjects

We searched the University of California, San Francisco Memory and Aging Center (UCSF MAC) database for all patients with a diagnosis of probable AD (McKhann et al., 1984), behavioral variant FTD (Neary et al., 1998), or neurologically healthy control who received a 1.5 T high-definition MR anatomical scan within 90 days of figure copy assessment and scored at least 18 on the Mini Mental State Examination (MMSE; Folstein, Folstein, & McHugh, 1975). When there was more than one visit when the

Results

Demographic characteristics and figure copy scores by diagnostic group are presented in Table 1. In the full sample, the diagnostic groups did not differ significantly in age, F(2, 185) = 2.13, p = .12, or in the proportion of males, F(2, 185) = .68, p = .51. MMSE scores differed between the groups, F(2, 185) = 95.55, p < .001. Tukey follow-up procedure (p < .05) indicated that the ADs scored lower on the MMSE than the bvFTD patients, d = .65, and the controls, d = 2.54, and the bvFTD patients scored lower than

Discussion

The results of this study suggest that AD and bvFTD patients fail tests of figure copy because of different anatomical substrates and distinctive cognitive mechanisms. Poor figure copy performance in AD was associated with smaller rPC volumes, but was not associated with rDLPFC volumes. In contrast, in bvFTD, poor figure copy performance was associated with smaller rDLPFC volumes, and there was only a trend for an association with smaller rPC volumes. Right lateral temporal lobe volumes were

Acknowledgements

This work was supported by 2008-A-020-FEL and 2007/2I from the Larry L. Hillblom Foundation and 5 P01 AG019724, 3 P50 AG023501, and 5 R01 AG022983-05 from the National Institute on Aging.

References (70)

  • F. Segonne et al.

    A hybrid approach to the skull stripping problem in MRI

    Neuroimage

    (2004)
  • S.J. Teipel et al.

    Resting state glucose utilization and the CERAD cognitive battery in patients with Alzheimer's disease

    Neurobiology of Aging

    (2006)
  • J.L. Whitwell et al.

    Imaging correlates of posterior cortical atrophy

    Neurobiology of Aging

    (2007)
  • J.J. Barton

    Higher cortical visual function

    Current Opinion in Ophthalmology

    (1998)
  • A.L. Boxer et al.

    Focal right inferotemporal atrophy in AD with disproportionate visual constructive impairment

    Neurology

    (2003)
  • A.L. Boxer et al.

    Cinguloparietal atrophy distinguishes Alzheimer disease from semantic dementia

    Archives of Neurology

    (2003)
  • H. Braak et al.

    Evolution of neuronal changes in the course of Alzheimer's disease

    Journal of Neural Transmission Supplementum

    (1998)
  • S.K. Chester et al.

    The neural correlates of design fluency repetition errors and implications for the diagnosis of Frontotemporal Dementia

  • V. de Simone et al.

    Driving abilities in frontotemporal dementia patients

    Dementia and Geriatric Cognitive Disorders

    (2007)
  • A.R. deIpolyi et al.

    Spatial cognition and the human navigation network in AD and MCI

    Neurology

    (2007)
  • D.C. Delis et al.

    The Delis–Kaplan Executive Function System

    (2001)
  • J. Diehl et al.

    Frontotemporal dementia: Patient characteristics, cognition, and behaviour

    International Journal of Geriatric Psychiatry

    (2002)
  • C. Elfgren et al.

    Neuropsychological test as discriminators between dementia of Alzheimer type and frontotemporal dementia

    International Journal of Geriatric Psychiatry

    (1994)
  • J. Ernst et al.

    Car driving ability of patients with frontotemporal lobar degeneration and Alzheimer's disease

    Nervenarzt

    (2007)
  • B. Fischl et al.

    Measuring the thickness of the human cerebral cortex from magnetic resonance images

    Proc Natl Acad Sci USA

    (2000)
  • B. Fischl et al.

    Automated manifold surgery: constructing geometrically accurate and topologically correct models of the human cerebral cortex

    IEEE Trans Med Imaging

    (2001)
  • B. Fischl et al.

    Sequence-independent segmentation of magnetic resonance images

    Neuroimage

    (2004)
  • B. Fischl et al.

    High-resolution intersubject averaging and a coordinate system for the cortical surface

    Hum Brain Mapp

    (1999)
  • B. Fischl et al.

    Automatically parcellating the human cerebral cortex

    Cereb Cortex

    (2004)
  • R.Q. Freeman et al.

    Visuoconstructional problems in dementia: Contribution of executive systems functions

    Neuropsychology

    (2000)
  • G.B. Frisoni et al.

    Dementia of the frontal type: Neuropsychological and [99Tc]-HM-PAO SPET features

    Journal of Geriatric Psychiatry and Neurology

    (1995)
  • M. Gasparini et al.

    A descriptive study on constructional impairment in frontotemporal dementia and Alzheimer's disease

    European Journal of Neurology

    (2008)
  • L. Hamilton et al.

    Misplacing objects in mild to moderate Alzheimer's disease: A descriptive analysis from the VISTA clinical trial

    Journal of Neurology, Neurosurgery, and Psychiatry

    (2009)
  • J.V. Haxby et al.

    Longitudinal study of cerebral metabolic asymmetries and associated neuropsychological patterns in early dementia of the Alzheimer type

    Archives of Neurology

    (1990)
  • K. Ishii et al.

    Voxel-based morphometric comparison between early- and late-onset mild Alzheimer's disease and assessment of diagnostic performance of z score images

    AJNR American Journal of Neuroradiology

    (2005)
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