Abstract
Background: When navigating in a particular space, a sense of being at a current location is of great help for the navigators in reaching their destination or getting back to the start. To accomplish this work, interwoven neural structures and neurons are called into play. This system is called the heading direction cell-place cell-grid cell circuit. Evidence from various neuroscience studies has revealed that the regions responsible for this circuit are damaged in the early stages of Alzheimer's disease (AD). This may explain why wayfinding difficulty is one of the most frequent symptoms in persons with AD. The aim of this study was to examine the sense of location (SoL) in persons with mild AD, persons with prodromal AD (prAD), and those who were cognitively unimpaired (CU).Methods: We invited people with mild AD, prAD, and CU to participate in this study. The venue of the core experiment to assess SoL was a 660-m path located on the university campus. The participants were instructed to take a walk on the path and press a device to indicate their arrival at each of the five carefully chosen targets. The linear deviations from the target site were compared among the groups.Results: A total of 20 AD, 28 prAD, and 29 CU persons completed the study. Their Mini-Mental State Examination scores were on average 20 (SD 3), 24 (SD 3), and 28 (SD 2). The groups were well differentiated regarding several measurements for cognitive ability and spatial navigation. As for the SoL, the hit rates of exact location with linear deviation of 16 m or less were 0.05, 0.54, and 0.86 for AD, prAD, and CU persons, respectively. The hit rates were well correlated with the presence of getting lost. Also, SoL differentiated well among CU, PrAD, and AD in terms of average linear deviation.Conclusions: Our employing linear deviation by utilizing a grid-cell function device as an assessment for SoL showed distinct features among the three groups. This model can be used to develop more delicate devices or instruments to detect, monitor, and aid spatial navigation in persons with prAD and AD.
Highlights
When navigating in a particular space, a sense of being at a current location is of great help for the navigators in reaching their destination or getting back to the start
The aim of this study was to examine the sense of location (SoL) in persons with mild Alzheimer’s disease (AD), persons with prodromal AD, and those who were cognitively unimpaired (CU)
AD and prodromal AD (prAD) were more impaired in spatial navigation than CU as assessed by Questionnaire on Everyday Navigational Ability (QuENA), while they showed no difference between each other
Summary
When navigating in a particular space, a sense of being at a current location is of great help for the navigators in reaching their destination or getting back to the start. SoL helps an individual to reach his or her destination and return to the start point To accomplish this seemingly simple work, interwoven neural structures are called into play. It is known that a network in the brain provides navigators with knowledge of their current location and a representation of environmental scenes This global positioning system (GPS)-like built-in neural network is called the place cell-heading direction cell-grid cell (PHG) system (Golob et al, 2001; Parron and Save, 2004; Hafting et al, 2005). The neural structures composing this system overlap with the regions which are damaged in the initial stage of Alzheimer’s disease (AD) (Braak and Del Tredici, 2015), including the entorhinal cortex and its connected regions This may explain why navigation impairment and getting lost (GL) are two of the incipient symptoms in persons with AD (Pai and Hsiao, 2002; Pai and Jacobs, 2004)
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