Nonverbal visual attention, but not recognition memory or learning, processes are impaired in motor neurone disease

Pathology outside the motor system is being increasingly recognised in motor neurone disease (MND) and up to 3% of patients may have overt dementia of frontal lobe type; it is not clear whether milder cognitive disturbance is a more frequent feature of the disease. Standard neuropsychological testing can be difficult in MND and we therefore used the microcomputer-controlled Cambridge Neuropsychological Test Automated Battery (CANTAB((C))), which allows accurate assessment in the presence of motor and bulbar dysfunction. The results of subtests evaluating nonverbal visual attention, recognition memory and learning from a large (n = 50) group of patients with MND compared to normal (n = 27) and neurological disease (n = 23) control groups are presented in this report. The MND group showed significant impairment in a focal attention (visual search) task, but no deficits in memory or learning. Inspection of the visual search data showed that up to a quarter of the MND patients scored two or more standard deviations below the mean control score. It is suggested that this reflects pathology in fronto-striatal circuitry.