Overestimation in angular path integration precedes Alzheimer's dementia

A cognitive-motor framework for spatial navigation in aging and early-stage Alzheimer's disease

Spatial navigation is essential for wellbeing and independence and shows significant declines as part of age-related neurodegenerative disorders, such as Alzheimer's disease. Navigation is also one of the earliest behaviors impacted by this devastating disease. Neurobiological models of aging and spatial navigation have focused primarily on the cognitive factors that account for impaired navigation abilities during the course of healthy aging and early stages of preclinical and prodromal Alzheimer's disease. The contributions of physical factors that are essential to planning and executing movements during successful navigation, such as gait and dynamic balance, are often overlooked despite also being vulnerable to early stages of neurodegenerative disease. We review emerging evidence that spatial navigation and functional mobility each draw on highly overlapping sensory systems, cognitive processes, and brain structures that are susceptible to healthy and pathological aging processes. Based on this evidence, we provide an alternative to models that have focused primarily on spatial navigation as a higher order cognitive function dependent on brain areas such as the hippocampus and entorhinal cortex. Instead, we argue that spatial navigation may offer an ecologically valid cognitive-motor phenotype of age-related cognitive dysfunction. We propose that dual cognitive-motor deficits in spatial navigation may arise from early changes in neuromodulatory and peripheral sensory systems that precede changes in regions such as the entorhinal cortex.

Self-supervised learning of scale-invariant neural representations of space and time

Hippocampal representations of space and time seem to share a common coding scheme characterized by neurons with bell-shaped tuning curves called place and time cells. The properties of the tuning curves are consistent with Weber's law, such that, in the absence of visual inputs, width scales with the peak time for time cells and with distance for place cells. Building on earlier computational work, we examined how neurons with such properties can emerge through self-supervised learning. We found that a network based on autoencoders can, given a particular inputs and connectivity constraints, produce scale-invariant time cells. When the animal's velocity modulates the decay rate of the leaky integrators, the same network gives rise to scale-invariant place cells. Importantly, this is not the case when velocity is fed as a direct input to the leaky integrators, implying that weight modulation by velocity might be critical for developing scale-invariant spatial receptive fields. Finally, we demonstrated that after training, scale-invariant place cells emerge in environments larger than those used during training. Taken together, these findings bring us closer to understanding the emergence of neurons with bell-shaped tuning curves in the hippocampus and highlight the critical role of velocity modulation in the formation of scale-invariant place cells.

Path integration impairments reveal early cognitive changes in Subjective Cognitive Decline

Path integration, the ability to track one's position using self-motion cues, is critically dependent on the grid cell network in the entorhinal cortex, a region vulnerable to early Alzheimer's disease pathology. In this study, we examined path integration performance in individuals with subjective cognitive decline (SCD), a group at increased risk for Alzheimer's disease, and healthy controls using an immersive virtual reality task. We developed a Bayesian computational model to decompose path integration errors into distinct components. SCD participants exhibited significantly higher path integration error, primarily driven by increased memory leak, while other modelling-derived error sources, such as velocity gain, sensory and reporting noise, remained comparable across groups. Our findings suggest that path integration deficits, specifically memory leak, may serve as an early marker of neurodegeneration in SCD and highlight the potential of self-motion-based navigation tasks for detecting pre-symptomatic Alzheimer's disease-related cognitive changes.

Teaser

Virtual reality, computational modelling, and biomarkers uncover path integration deficits, distinguishing pre-symptomatic Alzheimer's from normal aging.

Rotation errors in path integration are associated with Alzheimer's disease tau pathology: a cross-sectional study

BACKGROUND

Early Alzheimer's disease diagnosis is crucial for preventive therapy development. Standard neuropsychological evaluation does not identify clinically normal individuals with brain amyloidosis, the first stage of the pathology, defined as preclinical Alzheimer's disease. Spatial navigation assessment, in particular path integration, appears promising to detect preclinical symptoms, as the medial temporal lobe plays a key role in navigation and is the first cortical region affected by tau pathology.

METHODS

We have conducted a cross-sectional study. We related the path integration performance of 102 individuals without dementia, aged over 50, to amyloid and tau pathologies, measured using positron emission tomography. We included 75 clinically normal individuals (19 with brain amyloidosis, 56 without) and 27 individuals with mild cognitive impairment (18 with brain amyloidosis, 9 without). We fitted linear mixed models to predict the path integration performances according to amyloid status or tau pathology in the medial temporal lobal, adjusting for age, gender, cognitive status, education, and video game experience. We decomposed the error into rotation and distance errors.

RESULTS

We observed that clinically normal adults with brain amyloidosis (preclinical Alzheimer's disease) had spatial navigation deficits when relying only on self-motion cues. However, they were able to use a landmark to reduce their errors. Individuals with mild cognitive impairment had deficits in path integration that did not improve when a landmark was added in the environment. The amyloid status did not influence performance among individuals with mild cognitive impairment. Among all individuals, rotation, but not distance, errors increased with the level of tau pathology in the medial temporal lobe.

CONCLUSION

Our results suggest that path integration performance in an environment without external cues allows identifying individuals with preclinical Alzheimer's disease, before overt episodic memory impairment is noticeable. Specifically, we demonstrated that poor angular estimation is an early cognitive marker of tau pathology, whereas distance estimation relates to older ages, not to Alzheimer's disease.

TRIAL REGISTRATION

Eudra-CT 2018-003473-94.

An experimental framework for conjoint measures of olfaction, navigation, and motion as pre-clinical biomarkers of Alzheimer's disease

Elucidating Alzheimer's disease (AD) prodromal symptoms can resolve the outstanding challenge of early diagnosis. Based on intrinsically related substrates of olfaction and spatial navigation, we propose a novel experimental framework for their conjoint study. Artificial intelligence-driven multimodal study combining self-collected olfactory and motion data with available big clinical datasets can potentially promote high-precision early clinical screenings to facilitate timely interventions targeting neurodegenerative progression.

Early and specific detection of Alzheimer's disease: more than a (virtual) reality?

This scientific commentary refers to 'Path integration deficits are associated with phosphorylated tau accumulation in the entorhinal cortex', by Koike et al. (https://doi.org/10.1093/braincomms/fcad359).

Path Integration Detects Prodromal Alzheimer's Disease and Predicts Cognitive Decline

Background

The entorhinal cortex is the very earliest involvement of Alzheimer's disease (AD). Grid cells in the medial entorhinal cortex form part of the spatial navigation system.

Objective

We aimed to determine whether path integration performance can be used to detect patients with mild cognitive impairment (MCI) at high risk of developing AD, and whether it can predict cognitive decline.

Methods

Path integration performance was assessed in 71 patients with early MCI (EMCI) and late MCI (LMCI) using a recently developed 3D virtual reality navigation task. Patients with LMCI were further divided into those displaying characteristic brain imaging features of AD, including medial temporal lobe atrophy on magnetic resonance imaging and posterior hypoperfusion on single-photon emission tomography (LMCI+), and those not displaying such features (LMCI-).

Results

Path integration performance was significantly lower in patients with LMCI+than in those with EMCI and LMCI-. A significantly lower performance was observed in patients who showed progression of MCI during 12 months, than in those with stable MCI. Path integration performance distinguished patients with progressive MCI from those with stable MCI, with a high classification accuracy (a sensitivity of 0.88 and a specificity of 0.70).

Conclusions

Our results suggest that the 3D virtual reality navigation task detects prodromal AD patients and predicts cognitive decline after 12 months. Our navigation task, which is simple, short (12-15 minutes), noninvasive, and inexpensive, may be a screening tool for therapeutic choice of disease-modifiers in individuals with prodromal AD.

rTMS regulates homotopic functional connectivity in the SCD and MCI patients

OBJECTIVE

Impaired interhemispheric connectivity and corpus callosum atrophy have been linked to cognitive impairment in Alzheimer's disease (AD). Existing evidence indicates that repetitive transcranial magnetic stimulation (rTMS) targeting the bilateral precuneus may enhance cognitive function in AD. This study aims to investigate the effects of precuneus rTMS on cognitive function, as well as alterations in interhemispheric functional connectivity (FC) and its structural basis in patients with subjective cognitive decline (SCD) and mild cognitive impairment (MCI).

METHODS

A total of 14 patients with SCD and 16 patients with MCI were enrolled in this study and received 10 Hz rTMS intervention on the bilateral precuneus for 2 weeks. Neurocognitive scales, structural and functional magnetic resonance imaging were collected at enrollment and after the rTMS intervention. Interhemispheric FC was assessed using mirror homotopic functional connectivity (VMHC), while the structural equation modeling (SEM) was employed to analyze the relationship between corpus callosum volume, interhemispheric connectivity, and cognitive function after rTMS intervention.

RESULTS

The precuneus rTMS not only enhanced episodic memory in SCD, but also improved multiple cognitive domains in MCI. Post-rTMS intervention, decreased VMHC values in the lingual cortex, middle occipital gyrus, putamen, and fusiform gyrus were observed in SCD, and an increased VMHC value in the postcentral gyrus along with reduced VMHC value in the cerebellum and putamen in MCI. After intervention, more brain regions show decreased FC in SCD and MCI patients, suggesting that precuneus rTMS may protect cerebral cortical plasticity by reducing excessive functional compensation, and thus improve cognitive function. The SEM indicated that the corpus callosum serves as the structural foundation for rTMS regulation of interhemispheric FC to further improve cognitive function.

CONCLUSION

10 Hz rTMS in the bilateral precuneus could be a promising strategy to improve cognitive function in patients with SCD and MCI. Our study implies that improvements in cognition brought about by precuneus rTMS may result from the remodeling of interhemispheric FC, with the corpus callosum possibly acting as the anatomical basis for functional modulation.