Cognitive-Motor Integration Performance Is Affected by Sex, APOE Status, and Family History of Dementia

Abstract

Background: Cognitive-motor integration (CMI) involves concurrent thought and action which requires the interaction of large brain networks. Given that early-stage dementia involves neural network dysfunction, deficits in CMI may prove useful for early dementia detection. Objective: Our research objective was to investigate sex-related differences in the ability to integrate rules into action. Methods: Based on family medical history, we recruited male and female participants both with and without dementia risk factors. Participants did not demonstrate cognitive impairment at the time of testing. Participants were tested on four increasingly dissociated visuomotor tasks (eye and hand movements were made in different spatial planes and/or visual feedback was reversed). Results: We observed significantly greater hand movement endpoint error scores and corrective path lengths in at-risk females compared to at-risk males in the most complex CMI condition (plane-change + feedback reversal). Multiple regression analyses revealed both sex and family history as significant predictors of worse performance in a CMI condition requiring visual feedback reversal. Further, the regression analyses provided preliminary evidence that having an APOE 4 allele was a significant predictor of poorer CMI performance in the two plane-change CMI conditions. Conclusion: These data suggest that underlying brain networks controlling simultaneous thought and action may differ between the sexes in ways that may be clinically relevant in dementia progression. Preliminary data also suggest an important connection between APOE variant and CMI performance in individuals at risk of developing dementia.

Challenging the relationship of grip strength with cognitive status in older adults

“…Despite the potential methodological concerns in relating grip strength to cognition, it is noted that other motor tasks may be of value, particularly since coordination of the upper extremity may be sensitive to cognitive ageing 26,27 . Upper extremity tasks that involve functional movement likely rely on more cognitive processes than maximal force production, which recruits primarily sensorimotor cortical regions.…”

Improving prediction of amyloid deposition in Mild Cognitive Impairment with a timed motor task

“…To minimize cost and assessment time and improve portability, we developed an upper extremity motor task that i) does not require any hardware or software; ii) can differentiate between cognitively intact and cognitively impaired individuals 8 better than other simple motor tasks (i.e., grip strength, see 9 ); and iii) is feasible for amnestic Mild Cognitive Impairment (MCI) cohorts 7,10 . This is in contrast to other assessments of complex movement that require demanding technology (e.g., movement sensors 6 , motion capture technology 5 , electromyography 4 , or transcranial magnetic stimulation 11 ) or do not show strong prognostic effects at baseline (e.g., 12 ). Given the relative advantages of this timed motor task and its prediction of functional decline in MCI, we hypothesized that task performance would be related to the extent of amyloid plaque deposition, and would improve the classification of amyloid positivity in individuals with amnestic MCI, above and beyond baseline cognitive and activities of daily living.…”

“…with disease severity [4][5][6] , recent work has also demonstrated that such movement may be sensitive to disease progression 7 when assessed with a timed motor task. To minimize cost and assessment time and improve portability, we developed an upper extremity motor task that i) does not require any hardware or software; ii) can differentiate between cognitively intact and cognitively impaired individuals 8 better than other simple motor tasks (i.e., grip strength, see 9 ); and iii) is feasible for amnestic Mild Cognitive Impairment (MCI) cohorts 7,10 .…”

Visuomotor integration deficits are common to familial and sporadic preclinical Alzheimer’s disease

“…As there is some evidence of sex differences in neural control of complex movements ( Gorbet and Sergio, 2007 ), and a previous study found that only females showed an association between dementia risk (based on family history of Alzheimer’s disease) and visuomotor integration impairments ( Rogojin et al , 2019 ), we conducted a post hoc analysis to test whether males and females differed in terms of the interaction between condition and group on circle-tracing accuracy. In the FAD sample, there was a three-way interaction between condition, group and sex (interaction coefficient = −0.42 [95% CIs: −0.82, −0.02], P = 0.040), such that female mutation carriers had disproportionately poorer tracing accuracy in the condition of indirect visual feedback (estimated interaction coefficient between condition and mutation status for females = 0.40 [0.12–0.67], P = 0.005), but this effect was not seen among males (estimated interaction coefficient between condition and mutation status for males = −0.02 [−0.32 – 0.27], P = 0.88).…”

“…Although visuomotor integration difficulties have received relatively little attention in Alzheimer’s disease—compared to the well-established impairments in memory, orientation and executive functions—deficits have been observed in Alzheimer’s patients and individuals at high Alzheimer’s disease risk, particularly under conditions where visual feedback is indirect (e.g. transformed with respect to the plane of movement) ( Tippett and Sergio, 2006 ; Tippett et al , 2007 ; Hawkins and Sergio, 2014 , 2016 ; Hawkins et al , 2015 ; Bartoli et al , 2017 ; Rogojin et al , 2019 ). It has been proposed that the early emergence of such deficits in Alzheimer’s disease may be linked to the vulnerability of the posterior parietal cortex—a region understood to be particularly important for co-ordinating information about eye and hand movements ( Tippett and Sergio, 2006 ; Hawkins and Sergio, 2014 ).…”