Impaired Processing of Serial Order Determines Working Memory Impairments in Alzheimer's Disease

Neural Patterns in Parietal Cortex and Hippocampus Distinguish Retrieval of Start versus End Positions in Working Memory

Coding serial order of information is a fundamental ability of our cognitive system, and still, little is known about its neural substrate. This study examined the neural substrates involved in the retrieval of information that is serially stored in verbal working memory task using a sensitive multivariate analysis approach. We compared neural activity for memorized items stemming from the beginning versus the end of a memory list assessing the degree of neural pattern discordance between order positions (beginning vs. end). The present results confirmed and refined the role of the intraparietal sulcus in the processing of serial order information in working memory. An important finding is that the hippocampus showed sensitivity to serial order information. Our results indicate that the representation of serial order information relies on a broader set of neural areas and highlight the role of the intraparietal sulcus and the hippocampus, in addition to the supramarginal gyrus and the SMA. The contribution of different neural regions might reflect the involvement of distinct levels of serial order coding (i.e., spatial, attentional, temporal) that support the representation of serial order information.

Allocentric Spatial Memory Performance in a Virtual Reality-Based Task is Conditioned by Visuospatial Working Memory Capacity

Traditionally, the medial temporal lobe has been considered a key brain region for spatial memory. Nevertheless, executive functions, such as working memory, also play an important role in complex behaviors, such as spatial navigation. Thus, the main goal of this study is to clarify the relationship between working memory capacity and spatial memory performance. Spatial memory was assessed using a virtual reality-based procedure, the Boxes Room task, and the visual working memory with the computer-based Change Localization Task. One hundred and twenty-three (n = 123) participants took part in this study. Analysis of Covariance (ANCOVA) revealed a statistically significant relationship between working memory capacity and spatial abilities. Thereafter, two subgroups n = 60, were formed according to their performance in the working memory task (1st and 4th quartiles, n = 30 each). Results demonstrate that participants with high working memory capacity committed fewer mistakes in the spatial task compared to the low working memory capacity group. Both groups improved their performance through repeated trials of the spatial task, thus showing that they could learn spatial layouts independent of their working memory capacity. In conclusion, these findings support that spatial memory performance is directly related to working memory skills. This could be relevant for spatial memory assessment in brain lesioned patients.

Alzheimer's disease patients activate attention networks in a short-term memory task

Network functioning during cognitive tasks is of major interest in Alzheimer's disease (AD). Cognitive functioning in AD includes variable performance in short-term memory (STM). In most studies, the verbal STM functioning in AD patients has been interpreted within the phonological loop subsystem of Baddeley's working memory model. An alternative account considers that domain-general attentional processes explain the involvement of frontoparietal networks in verbal STM beside the functioning of modality-specific subsystems. In this study, we assessed the functional integrity of the dorsal attention network (involved in task-related attention) and the ventral attention network (involved in stimulus-driven attention) by varying attentional control demands in a STM task. Thirty-five AD patients and twenty controls in the seventies performed an fMRI STM task. Variation in load (five versus two items) allowed the dorsal (DAN) and ventral attention networks (VAN) to be studied. ANOVA revealed that performance decreased with increased load in both groups. AD patients performed slightly worse than controls, but accuracy remained above 70% in all patients. Statistical analysis of fMRI brain images revealed DAN activation for high load in both groups. There was no between-group difference or common activation for low compared to high load conditions. Psychophysiological interaction showed a negative relationship between the DAN and the VAN for high versus low load conditions in patients. In conclusion, the DAN remained activated and connected to the VAN in mild AD patients who succeeded in performing an fMRI verbal STM task. DAN was necessary for the task, but not sufficient to reach normal performance. Slightly lower performance in early AD patients compared to controls might be related to maintained bottom-up attention to distractors, to decrease in executive functions, to impaired phonological processing or to reduced capacity in serial order processing.

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Patients with early AD succeeded in performing an fMRI short-term memory task.

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Dorsal attention network activation did not differ between patients and controls.

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Dorsal and ventral attention networks remained connected in high load task in AD.

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DAN was necessary for the task, but not sufficient to reach normal performance.

Apolipoprotein E ε4 Specifically Modulates the Hippocampus Functional Connectivity Network in Patients With Amnestic Mild Cognitive Impairment

The presence of both apolipoprotein E (APOE) ε4 allele and amnestic mild cognitive impairment (aMCI) are considered to be risk factors for Alzheimer’s disease (AD). Numerous neuroimaging studies have suggested that the modulation of APOE ε4 affects intrinsic functional brain networks, both in healthy populations and in AD patients. However, it remains largely unclear whether and how ε4 allele modulates the brain’s functional network architecture in subjects with aMCI. Using resting-state functional magnetic resonance imaging (fMRI) and graph-theory approaches-functional connectivity strength (FCS), we investigate the topological organization of the whole-brain functional network in 28 aMCI ε4 carriers and 38 aMCI ε3ε3 carriers. In the present study, we first observe that ε4-related FCS increases in the right hippocampus/parahippocampal gyrus (HIP/PHG). Subsequent seed-based resting-state functional connectivity (RSFC) analysis revealed that, compared with the ε3ε3 carriers, the ε4 carriers had lower or higher RSFCs between the right HIP/PHG seed and the bilateral medial prefrontal cortex (MPFC) or the occipital cortex, respectively. Further correlation analyses have revealed that the FCS values in the right HIP/PHG and lower HIP/PHG-RSFCs with the bilateral MPFC were significantly correlated with the impairment of episodic memory and executive function in the aMCI ε4 carriers. Importantly, the logistic regression analysis showed that the HIP/PHG-RSFC with the bilateral MPFC predicted aMCI-conversion to AD. These findings suggest that the APOE ε4 allele may modulate the large-scale brain network in aMCI subjects, facilitating our understanding of how the entire assembly of the brain network reorganizes in response to APOE variants in aMCI. Further longitudinal studies need to be conducted, in order to examine whether these network measures could serve as primary predictors of conversion from aMCI ε4 carriers to AD.

Impaired serial ordering in nondemented patients with mild Parkinson's disease

The ability to arrange thoughts and actions in an appropriate serial order (the problem of serial order) is essential to complex behaviors such as language, reasoning and cognitive planning. Patients with Parkinson’s disease (PD) perform poorly in tasks that rely on the successful rearrangement of working memory representations. We hypothesized that serial ordering is impaired in nondemented patients with mild PD. We recruited 49 patients with mild idiopathic PD (Hoehn and Yahr Scale 1–2.5) and 51 matched healthy adults. Nineteen patients had normal global cognition (PD-NC, Montreal Cognitive Assessment, MoCA≥26/30) and thirty patients had mild cognitive impairment (PD-MCI, 21≤MoCA≤25). All participants underwent three working memory assessments: two experimental tests that require reordering random digits following a particular rule (adaptive digit ordering test and digit span backward test) and a control test that requires maintaining but no reordering (digit span forward test). PD-NC and PD-MCI patients performed significantly worse (with lower test scores and larger ordering costs) than healthy controls in both digit ordering and backward tests, although they performed normally in the forward test. The ordering cost increased as a function of age across groups, indicating an aging-related decline in the ability of serial ordering. However, individual patients’ task performances were not correlated with their severity or duration of motor symptoms, or daily exposure to dopaminergic drugs. These results suggested that serial ordering deficits exist in early stages of PD, prior to subtle changes in global cognition and in parallel with motor symptoms.