Department of Neurology, Johns Hopkins University School of Medicine, 1620 McElderry St., Reed Hall W102A, Baltimore, MD, 21205, USA.
Department of Neuroscience, Yale University, New Haven, CT, USA.
Cerebellum. 2019 Feb;18(1):33-46. doi: 10.1007/s12311-018-0948-z.
Poor visuospatial skills can disrupt activities of daily living. The cerebellum has been implicated in visuospatial processing, and patients with cerebellar injury often exhibit poor visuospatial skills, as measured by impaired memory for the figure within the Rey-Osterrieth complex figure task (ROCF). Visuospatial skills are an inherent aspect of the ROCF; however, figure organization (i.e., the order in which the figure is reconstructed by the participant) can influence recall ability. The objective of this study was to examine and compare visuospatial and organization skills in people with cerebellar ataxia. We administered the ROCF to patients diagnosed with cerebellar ataxia and healthy controls. The cerebellar ataxia group included patients that carried a diagnosis of spinocerebellar ataxia (any subtype), autosomal dominant cerebellar ataxia, or cerebellar ataxia with unknown etiology. Primary outcome measures were organization and recall performance on the ROCF, with supplemental information derived from cognitive tests of visuospatial perception, working memory, processing speed, and motor function. Cerebellar ataxia patients revealed impaired figure organization relative to that of controls. Figure copy was impaired in the patients, but their subsequent recall performance was normal, suggesting compensation from initial organization and copying strategies. In controls, figure organization predicted recall performance, but this relationship was not observed in the patients. Instead, processing speed predicted patients' recall accuracy. Supplemental tasks indicated that visual perception was intact in the cerebellar ataxia group and that performance deficits were more closely tied to organization strategies than with visuospatial skills.
空间视觉技能较差会干扰日常生活活动。小脑与空间视觉处理有关,小脑损伤患者的空间视觉技能通常较差,其表现在 Rey-Osterrieth 复杂图形测试(ROCF)中对图形的记忆受损。空间视觉技能是 ROCF 的固有组成部分;然而,图形组织(即参与者重建图形的顺序)会影响回忆能力。本研究旨在检查和比较小脑性共济失调患者的空间视觉和组织技能。我们向诊断为小脑性共济失调的患者和健康对照者施测了 ROCF。小脑性共济失调组包括诊断为脊髓小脑共济失调(任何亚型)、常染色体显性遗传性小脑共济失调或病因不明的小脑性共济失调的患者。主要的结果测量指标是 ROCF 的组织和回忆表现,辅助信息来源于空间视觉感知、工作记忆、处理速度和运动功能的认知测试。与对照组相比,小脑性共济失调患者的图形组织能力受损。患者的图形复制能力受损,但他们的后续回忆表现正常,这表明他们从初始组织和复制策略中得到了补偿。在对照组中,图形组织能力预测了回忆表现,但在患者中未观察到这种关系。相反,处理速度预测了患者的回忆准确性。辅助任务表明,小脑性共济失调组的视觉感知能力正常,而且表现缺陷与组织策略的关系更为密切,而不是与空间视觉技能有关。