Spatial navigation—a unique window into physiological and pathological aging

Abstract

Spatial navigation is a skill of determining and maintaining a trajectory from one place to another. Mild progressive decline of spatial navigation develops gradually during the course of physiological ageing. Nevertheless, severe spatial navigation deficit can be the first sign of incipient Alzheimer's disease (AD), occurring in the stage of mild cognitive impairment (MCI), preceding the development of a full blown dementia. Patients with amnestic MCI, especially those with the hippocampal type of amnestic syndrome, are at very high risk of AD. These patients present with the same pattern of spatial navigation impairment as do the patients with mild AD. Spatial navigation testing of elderly as well as computer tests developed for routine clinical use thus represents a possibility for further investigation of this cognitive domain, but most of all, an opportunity for making early diagnosis of AD.

Resting-state fMRI reveals enhanced functional connectivity in spatial navigation networks after transcranial direct current stimulation

“…For example, patients with mild cognitive impairment (MCI) or Alzheimer's dementia often demonstrate deficits in language, learning, and memory -including allocentric spatial navigation [1,13,18,22,31]. Thus, identifying a montage that modulates overlapping critical regions involved with each of these cognitive abilities could ultimately enhance performances across tasks.…”

“…Not surprisingly then, allocentric navigation is especially susceptible to age [18,22] and neurologic diseases like Alzheimer's disease [13,18,31], presumably due to pathologic changes within the core network described above. Thus, methods that enhance functioning within this network may ultimately hold promise for clinical treatment that improves everyday life.…”

Investigating virtual reality navigation in amnestic mild cognitive impairment using fMRI

“…When combining MCI, AD, and healthy controls, correlations have been seen between performance and the right hippocampus (DeIpolyi et al, 2007;Nedelska et al, 2012). Other work has shown an association between precuneus volume and performance within aMCI (Weniger et al, 2011).…”

“…When using navigation tasks in a functional imaging setting, the use of virtual reality tasks is critical. Such tasks have been validated in studies demonstrating highly correlated performance between real-world and virtual navigation within an MCI population (Cushman, Stein, & Duffy, 2008;Nedelska et al, 2012). Using virtual tasks, work has shown impairments in aMCI on route learning, but not landmark recognition (DeIpolyi, Rankin, Mucke, Miller, & Gorno-Tempini, 2007), and in navigating through a virtual park and maze (Weniger, Ruhleder, Lange, Wolf, & Irle, 2011).…”

“…Having the condition is widely considered to be a highly predictive risk factor for the development of Alzheimer's Disease (AD; Morris et al, 2001;Petersen, 2004) and there is therefore diverse research into identifying aMCI patients, understanding their cognitive impairments, and predicting later conversion to dementia (Blennow, Hampel, Weiner, & Zetterberg, 2010;Prvulovic, Bokde, Faltraco, & Hampel, 2011;Sperling, 2011;Wolk & Detre, 2012). There has been a recent emphasis on investigating spatial navigation in normal and pathological aging (Gazova et al, 2012;Iachini, Iavarone, Senese, Ruotolo, & Ruggiero, 2009;Lithfous, Dufour, & Després, 2013;Moffat, 2009). Spatial navigation impairments occur early in the progress of AD, where patients can be disoriented even in familiar surroundings (Henderson, Mack, & Williams, 1989;Monacelli, Cushman, Kavcic, & Duffy, 2003).…”