Visuospatial working memory is severely impaired in Bálint syndrome patients

Abstract

Although it has been proposed that visuospatial working memory may be impaired in Bálint syndrome patients, neither a systematic study concerning this proposal nor a comparison with patients having right-parietal damage has been made. Visuospatial working memory was assessed for six Bálint syndrome patients and members of two control groups-one composed of individuals with right-parietal damage (n = 15) and a second of age- and gender-matched healthy individuals (n = 26). We placed special emphasis on patients with a mild form of Bálint syndrome who can judge positional relationships between two objects. First, the participants were subjected to delayed visuospatial matching tasks. Next, their visuospatial-temporal integration abilities were assessed using a shape-from-moving-dots task. Visuospatial working memory was impaired for Bálint syndrome patients compared with controls according to the results of the tests. The differences between the Bálint syndrome and control subjects remained when only data for patients with the mild form of Bálint syndrome were included. We conclude that visuospatial working memory may be severely impaired in Bálint syndrome patients and, therefore, might influence their inability to properly execute movements and behaviours associated with daily living.

Balint Syndrome due to Bilateral Parieto-occipital Ischemic Stroke

“…Balint syndrome, which was first described by Balint in 1909, can be defined as a clinical presentation including defects consisting of psychic paralysis of gaze, spatial disorder of attention, and optic ataxia (1). In the literature, lesions mainly affecting the bilateral occipitoparietal lobes have been attributed to causing Balint syndrome (1,2). In the author's opinion, this report gives valuable findings, presenting a smart example of this rare syndrome, which is rarely illustrated in the literature.…”

Tapping Span Test as a Simple Diagnostic Tool for Patients With Initial-stage Posterior Cortical Atrophy: Short Tapping Span Length Indicates Visuospatial Working Memory Dysfunction

“…We therefore rst assessed if the participants could perceive several objects at a time and correctly judge the positional relationships of those objects, that is, their very basic visuospatial function. Detailed explanations of these tasks are provided elsewhere 27 . In short, the judgment of positional relationships of two probes and three probes was used to assess the presence of either psychic paralysis of gaze and/or severe dorsal simultanagnosia.…”

“…Visuospatial working memory was then measured by two task types: a delayed visuospatial matching task for visuospatial short-term memory and a shape-from-moving-dots task for more active visuospatial working memory. Detailed descriptions of these tasks are provided elsewhere 27 . The delayed visuospatial matching tasks that we used were much simpler than those used previously, given the severe visuospatial dysfunction of patients with posterior cortical atrophy, and consisted of two levels, that is, visuospatial working memory for one location and two locations, both of which included 30 trials.…”

“…Delayed matching task in onelocation condition 19.9 ± 8.7 28.9 ± 1.8 0.011 29.6 ± 0.9 [27] Delayed matching task in twolocation condition 13.1 ± 8.4 25.3 ± 2.7 0.0006 25.7 ± 3.7 [27] Shape-from-moving-dots task 1.3 ± 1.8 5.4 ± 3.4 0.01 7.8 ± 1.9 [27] The p-values in bold text are signi cant (i.e., <0.05). Abbreviations: CBS, Corticobasal Syndrome; CJD, Creutzfeldt-Jacob Disease, NA; not applicable; WAIS, Wechsler Adult Intelligence Scale…”

Clinical Reasoning: A 54-year-old woman with confusion and visual disturbances

“…6 These associated behavioral disturbances are likely caused by severe impairment of visual-spatial working memory, which influences a patient's inability to properly execute movements and behaviors associated with daily living. 7 Another unusual part of this case is the etiology of the patient's seizures. While seizures and NCSE are somewhat uncommon in hepatic encephalopathy, they can occur, often with no overt precipitating factors leading to the patient's ultimate diagnosis of NCSE.…”