Neuroimaging associations with spatial navigation impairment in Alzheimer’s disease continuum: A narrative review

Abstract

Identifying individuals with incipient Alzheimer’s disease (AD) are critical for early and targeted intervention before the dementia develops as AD progresses. Recently, emerging data have suggested that spatial navigation and neuroimaging could be utilized to identify individuals with prodromal AD. Compared to episodic memory, spatial navigation has fewer cultural and educational discrepancies and could serve as a promising marker for diagnosis and outcome measures in multicenter longitudinal studies with large cohorts. Furthermore, neuroimaging studies have contributed to our understanding of the structural and functional neural basis underlying spatial navigation and provided sensitive and non-invasive neuroimaging markers. The current review summarizes neuroimaging associations with spatial navigation impairment in the AD continuum, their potential pathophysiological mechanisms, and nonpharmacological interventions for spatial navigation impairments. We highlight the promising role of spatial navigation in the early identification of the preclinical and prodromal patients with potential risk of developing AD dementia. Multicenter large-scale longitudinal studies on patients across the AD continuum coupled with a standardized routine assessment of spatial navigation abilities in clinical settings are needed. This review may have implications for clinical practice and future research directions.