Spatial- and object-based attentional deficits in Alzheimer's disease - Relationship to HMPAO-SPECT measures of parietal perfusion

The purpose of this study was to investigate the ability of patients with Alzheimer's disease to shift attention between spatial locations and between objects, and to examine the brain regions involved in these cognitive operations using single photon emission computed tomography (SPECT) imaging. A recent study of patients with focal lesions provided evidence that the right and left parietal lobes are differentially involved in shifting selective attention from invalidly cued spatial locations and objects, respectively (Egly et al. J Exp Psychol Gen 1994; 123:161-77). Accordingly, in Alzheimer's disease patients, we hypothesized that right parietal hypoperfusion on SPECT would be associated with deficits on the spatial-based component of a cued reaction time task, and left parietal hypoperfusion would be associated with the deficits on the object-based component. Attentional performance of Alzheimer's disease patients (n = 29) was compared with age-matched normal controls (n = 27) wing a cued reaction time task based on Egly et al. (1994). Regions of interest were defined semi-automatically on SPECT, and were anatomically localized with the aid of co-registered MRI. As hypothesized, in Alzheimer's disease patients, reaction time costs of invalid targets eliciting shifts of attention between spatial locations were selectively correlated with SPECT hypoperfusion in the right superior parietal lobe; while reaction time costs of between-object shifts of attention were correlated with hypoperfusion in the left inferior parietal lobe. These results provide evidence for the specialized roles of the right and left parietal regions in the spatial and object components of attentional shifting respectively, and suggest that the cognitive profile associated with Alzheimer's disease includes both spatial- and object-based attentional impairments.