Spatial working memory in Alzheimer's disease: A study using the Corsi block-tapping test

Guariglia, Carla Cristina

doi:10.1590/S1980-57642008DN10400011

Abstract

The Corsi block-tapping test was developed as a non-verbal task to measure spatial memory. In this test, cubes are tapped by the examiner in novel sequences of increasing length after which participants are required to reproduce each sequence immediately. Objectives: To evaluate spatial working memory in Alzheimer's disease (AD) patients. Methods: 30 elderly control subjects (21 women, 9 men) and 30 patients with probable Alzheimer's disease (15 women and 15 men), with 8 or more years of schooling, were evaluated with the Mini-Mental State Examination (MMSE), digit span and Corsi block-tapping test. Proportions were compared using Chi-Square, and continuous variables with the Mann-Whitney tests. Results: AD patients were older than controls (p=0.014), but there were no differences regarding gender or educational level between these groups. The performance on the Corsi block-tapping test differed between AD and control individuals (p=0.010), and between patients with moderate dementia and controls (p=0.032), but not between control individuals and patients with mild dementia (p=0.090). Conclusions: In the present study, AD patients with moderate dementia showed impairment in spatial working memory while those with mild dementia did not. This finding may be due to the relatively small sample size, but it is also possible that spatial memory may be normal in the initial (limbic) phase of AD.

Key words:
working memory; Alzheimer's disease; Corsi block-tapping test; spatial memory; non-verbal memory

Resumo

O teste dos blocos de Corsi (TBC) foi desenvolvido como uma medida não verbal da memória operacional espacial (MOE). Os blocos devem ser tocados pelo examinador em seqüências crescentes e os participantes devem repetir cada seqüência. Objetivos: Avaliar a MOE em pacientes com DA. Métodos: 30 sujeitos controles (21 mulheres, 9 homens) e 30 pacientes com DA provável (15 mulheres, 15 homens) com escolaridade superior a 8 anos foram avaliados através do Mini Exame do Estado Mental (MEEM), extensão de dígitos, fluência verbal e TBC. Os dados foram comparados através do teste do qui-quadrado e as variáveis contínuas através do teste de Mann-Whitney. Resultados: Pacientes com DA eram mais velhos (p=0,014), mas não houve diferença quanto ao gênero ou escolaridade. O desempenho no teste dos blocos de Corsi foi diferente entre os pacientes com DA e sujeitos controles (p=0,010) e entre pacientes com demência de intensidade moderada e controles (p=0,032), mas não houve diferença entre pacientes com DA leve e controles (p=0,090). Conclusões: No presente estudo, pacientes com DA moderada demonstraram comprometimento na memória operacional espacial, o que não foi demonstrado nos pacientes com demência leve. Este achado pode estar relacionado ao pequeno tamanho da amostra, mas também é possível que a memória operacional espacial esteja normal na fase inicial (límbica) da DA.

Palavras-chave:
memória operacional; doença de Alzheimer; teste dos blocos de Corsi; memória espacial; memória não-verbal

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References

¹
Baddeley A. Working memory and language: an overview. J Commun Disord 2003;36:189-208.
²
Della Sala S, Logie RH. Neuropsychological impairments of visuals and spatial working memory. In: Alan D. Baddeley, Michael D. Kopelman, Barbara A. Wilson, Editors. The handbook of memory disorders. New York: John Wiley and Sons; 2002:271-292.
³
Ungerleider LG, Courtney SF, Haxby JB. A neural system for human visual working memory. Proc Natl Acad Sci 1998;95:883-890.
⁴
Van Asselen M, Kessels RPC, Neggers SFW, Kapelle LJ, Frijns CJM, Postma A. Brain areas involved in spatial working memory. Neuropsychologia 2006;44:1185-1194.
⁵
Milner B. Interhemispheric differences in the localization of psychological processes in man. Br Med Bull 1971;27:272-277.
⁶
Souza-Talarico JN, Caramelli P, Nitrini R, Chaves EC. The influence of schooling on working memory performance in elderly individuals without cognitive decline. Dement Neuropsychol 2007;1(3):276-281.
⁷
Busch RM, Farrel K, Lisdahl-Medina K, Orian RK. Corsi block-tapping task performance as a function of path configuration. J Clin Exp Neuropsychol 2005;27:127-134.
⁸
Baddeley AD, Bressi S, Della Sala S, Logie R, Spinnler H.The decline of working memory in Alzheimer's disease. Brain 1991;114:2521-2542.
⁹
Liu L, Gauthier L, Gauthier S. Spatial disorientation in persons with early senile dementia of the Alzheimer's Type. Am J Occup Ther 1991;45:67-74.
¹⁰
Grossi D, Becker JT, Smith C, Trojano L. Memory for visuospatial patterns in Alzheimer's disease. Psychol Med 1993;23:65-70.
¹¹
Trojano L, Chiacchio L, Luca G, Fragassi NA, Grossi D. Effect of testing procedure on Corsi's block tapping test in normal subjects and Alzheimer's disease. Percept Mot Skills 1994;78:859-863.
¹²
McKhan G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical diagnosis of Alzheimer's Disease:report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer´s Disease. Neurology 1984;34:939-944.
¹³
Nitrini R, Caramelli P, Herrera Junior E, et al. Performance of illiterate and literate nondemented elderly subjects in two tests of long-term memory. J Int Neuropsychol Soc 2004;10:634-638.
¹⁴
Nitrini R, Lefevre BH, Mathias SC, et al. Neuropsychological tests of simple application for diagnosing dementia. Arq Neuropsiquiatr 1994;52:457-465.
¹⁵
Folstein MF, Folstein SE, McHugh PR. Mini-Mental State: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189-198.
¹⁶
Brucki SM, Nitrini R, Caramelli P, Bertolucci PH, Okamoto IH. Suggestions for utilization of the mini-mental state examination in Brazil. Arq Neuropsiquiatr 2003;61:777-781.
¹⁷
Hale S, Myerson J, Emery L J, Lawrence B M, DuFault C. Variation in working memory across the life span. In: Conway ARA, Jarrold C, Kane M J, Miyake A, Towse JN, editors. Variation in Working Memory. New York: Oxford University Press; 2007.

Publication Dates

Publication in this collection
Oct-Dec 2007

History

Received
04 Nov 2007
Reviewed
28 Nov 2007
Accepted
29 Nov 2007

This is an open-access article distributed under the terms of the Creative Commons Attribution License

[1] ¹
Baddeley A. Working memory and language: an overview. J Commun Disord 2003;36:189-208.

[2] ²
Della Sala S, Logie RH. Neuropsychological impairments of visuals and spatial working memory. In: Alan D. Baddeley, Michael D. Kopelman, Barbara A. Wilson, Editors. The handbook of memory disorders. New York: John Wiley and Sons; 2002:271-292.

[3] ³
Ungerleider LG, Courtney SF, Haxby JB. A neural system for human visual working memory. Proc Natl Acad Sci 1998;95:883-890.

[4] ⁴
Van Asselen M, Kessels RPC, Neggers SFW, Kapelle LJ, Frijns CJM, Postma A. Brain areas involved in spatial working memory. Neuropsychologia 2006;44:1185-1194.

[5] ⁵
Milner B. Interhemispheric differences in the localization of psychological processes in man. Br Med Bull 1971;27:272-277.

[6] ⁶
Souza-Talarico JN, Caramelli P, Nitrini R, Chaves EC. The influence of schooling on working memory performance in elderly individuals without cognitive decline. Dement Neuropsychol 2007;1(3):276-281.

[7] ⁷
Busch RM, Farrel K, Lisdahl-Medina K, Orian RK. Corsi block-tapping task performance as a function of path configuration. J Clin Exp Neuropsychol 2005;27:127-134.

[8] ⁸
Baddeley AD, Bressi S, Della Sala S, Logie R, Spinnler H.The decline of working memory in Alzheimer's disease. Brain 1991;114:2521-2542.

[9] ⁹
Liu L, Gauthier L, Gauthier S. Spatial disorientation in persons with early senile dementia of the Alzheimer's Type. Am J Occup Ther 1991;45:67-74.

[10] ¹⁰
Grossi D, Becker JT, Smith C, Trojano L. Memory for visuospatial patterns in Alzheimer's disease. Psychol Med 1993;23:65-70.

[11] ¹¹
Trojano L, Chiacchio L, Luca G, Fragassi NA, Grossi D. Effect of testing procedure on Corsi's block tapping test in normal subjects and Alzheimer's disease. Percept Mot Skills 1994;78:859-863.

[12] ¹²
McKhan G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical diagnosis of Alzheimer's Disease:report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer´s Disease. Neurology 1984;34:939-944.

[13] ¹³
Nitrini R, Caramelli P, Herrera Junior E, et al. Performance of illiterate and literate nondemented elderly subjects in two tests of long-term memory. J Int Neuropsychol Soc 2004;10:634-638.

[14] ¹⁴
Nitrini R, Lefevre BH, Mathias SC, et al. Neuropsychological tests of simple application for diagnosing dementia. Arq Neuropsiquiatr 1994;52:457-465.

[15] ¹⁵
Folstein MF, Folstein SE, McHugh PR. Mini-Mental State: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189-198.

[16] ¹⁶
Brucki SM, Nitrini R, Caramelli P, Bertolucci PH, Okamoto IH. Suggestions for utilization of the mini-mental state examination in Brazil. Arq Neuropsiquiatr 2003;61:777-781.

[17] ¹⁷
Hale S, Myerson J, Emery L J, Lawrence B M, DuFault C. Variation in working memory across the life span. In: Conway ARA, Jarrold C, Kane M J, Miyake A, Towse JN, editors. Variation in Working Memory. New York: Oxford University Press; 2007.

Brazil