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

Qian Chen^1,2,3†, Futao Chen^2,3,4†, Cong Long^2,3,4†, Jiaming Lu^2,3,4, Jiu Chen^5,6, Jun Chen⁷, Zuzana Nedelska^8,9, Jakub Hort^8,9, Bing Zhang^{1,2,3,4,10,11*}

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¹ Department of Radiology, Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, China

² Medical Imaging Center, Affiliated Drum Tower Hospital, Medical School of Nanjing University

³ Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, China

⁴ Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China

⁵ Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China

⁶ Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, China

⁷ Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA

⁸ Memory Clinic, Department of Neurology, 2nd Faculty of Medicine, Charles University, University Hospital Motol, Prague, Czechia

⁹ International Clinical Research Center, St. Anne’s University Hospital Brno, Brno, Czechia

¹⁰ Jiangsu Key Laboratory of Molecular Medicine, Nanjing, China

¹¹ Institute of Brain Science, Nanjing University, Nanjing, China

†These authors contributed equally to this work.

Advanced Neurology 2022, 1(2), 145 https://doi.org/10.36922/an.v1i2.145

Received: 1 July 2022 | Revised: 29 July 2022 | Published online: 30 August 2022

© 2022 by the Authors. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )

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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.

Keywords

Spatial navigation

Alzheimer’s disease

Neuroimaging

Functional connectivity

Funding

National Science and Technology Innovation 2030 - Major Program of “Brain Science and Brain-Like Research”

National Natural Science Foundation of China

Key Scientific Research Project of Jiangsu Health Committee

Industry and Information Technology Department of Nanjing

Educational Research Project of Nanjing Medical University

Project of Nanjing Health Science and Technology Development

Clinical Trials from the Affiliated Drum Tower Hospital, Medical School of Nanjing University

Conflict of interest

The authors report no conflicts of interest.

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