AccScience Publishing / AN / Volume 1 / Issue 2 / DOI: 10.36922/an.v1i2.145
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Neuroimaging associations with spatial navigation impairment in Alzheimer’s disease continuum: A narrative review

Qian Chen1,2,3† Futao Chen2,3,4† Cong Long2,3,4† Jiaming Lu2,3,4 Jiu Chen5,6 Jun Chen7 Zuzana Nedelska8,9 Jakub Hort8,9 Bing Zhang1,2,3,4,10,11*
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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
Advanced Neurology 2022, 1(2), 145
Submitted: 1 July 2022 | Revised: 29 July 2022 | Published: 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 ( )

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.

Spatial navigation
Alzheimer’s disease
Functional connectivity
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

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Conflict of interest
The authors report no conflicts of interest.
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Advanced Neurology, Electronic ISSN: 2810-9619 Published by AccScience Publishing