Dr Andrea Tales Research Fellow University of Bristol Department of Experimental Psychology Visual Attention-related processing in Mild Cognitive Impairment & Visual Attention-related processing in Mild Cognitive Impairment & Alzheimer’s Disease

Collaborative Links Dr Tony Bayer (Llandough Hospital, Memory clinic). Dr Tony Bayer (Llandough Hospital, Memory clinic). Prof. Gordon Wilcock (Oxford). Prof. Gordon Wilcock (Oxford). Prof. Robert Snowden (School of Psychology, Cardiff) Prof. Robert Snowden (School of Psychology, Cardiff) Dr Judy Haworth (The BRACE Centre, Bristol). Dr Judy Haworth (The BRACE Centre, Bristol). Dr Stuart Butler (The Burden Institute, Bristol). Dr Stuart Butler (The Burden Institute, Bristol). Dr Gillian Porter (Psychology, Bristol). Dr Gillian Porter (Psychology, Bristol).

Attention: why study it in MCI and AD? Much is known about visual attention in healthy individuals. Much is known about visual attention in healthy individuals. Tests of such function can be completed successfully by those with MCI and AD; therefore potentially of clinical utility. Tests of such function can be completed successfully by those with MCI and AD; therefore potentially of clinical utility.

Attention networks Attention used to describe many brain functions. AD is traditionally characterised in relation to attentional deficits in relation to executive function. Attention used to describe many brain functions. AD is traditionally characterised in relation to attentional deficits in relation to executive function. We study specific, more fundamental aspects of attention: We study specific, more fundamental aspects of attention:  disengagement and shifting of attentional focus to specific locations  Inhibition of return  Phasic alerting  Automatic change detection

Anatomy of Attentional networks Independent attentional networks: each type of attention associated with specific cortical regions and neurotransmitters. Independent attentional networks: each type of attention associated with specific cortical regions and neurotransmitters. Attentional disengagement and shifting: frontoparietal network; Acetylcholine Attentional disengagement and shifting: frontoparietal network; Acetylcholine Phasic alerting: parietal, frontal regions; noradrenaline. Phasic alerting: parietal, frontal regions; noradrenaline.

Anatomy and function Evidence of AD-related pathological change in areas of brain associated with visual attention. Plaques and Tangles in Parietal cortices and in occipital cortex. AD-related abnormalities in both cholinergic and noradrenergic function. Evidence of AD-related pathological change in areas of brain associated with visual attention. Plaques and Tangles in Parietal cortices and in occipital cortex. AD-related abnormalities in both cholinergic and noradrenergic function. Evidence of pathology in sub-cortical nuclei in AD; including nucleus basalis of Meynert (cholinergic function; attentional disengagement and shifting) and in locus coereleus (adrenergic function; phasic alerting). Evidence of pathology in sub-cortical nuclei in AD; including nucleus basalis of Meynert (cholinergic function; attentional disengagement and shifting) and in locus coereleus (adrenergic function; phasic alerting).

How can the study of visual attention help in the diagnosis of MCI and AD? Functional integrity of visual selective attention is necessary for high level cognitive and perceptual processing and therefore for appropriate environmental interaction. Functional integrity of visual selective attention is necessary for high level cognitive and perceptual processing and therefore for appropriate environmental interaction. Attention-related deficits in AD should be apparent in those with MCI who later develop AD. Attention-related deficits in AD should be apparent in those with MCI who later develop AD. Potential for early disease marker? Potential for early disease marker? Increased understanding of the disease process. Does AD affect low level/automatic processing too? Increased understanding of the disease process. Does AD affect low level/automatic processing too? Increased awareness of what patients with these disorders may be experiencing. Increased awareness of what patients with these disorders may be experiencing.

What form of visual attention-related function do we study? Exogenous cue-induced spatial orienting and disengagement and inhibition of return (Posner cueing paradigm). Exogenous cue-induced spatial orienting and disengagement and inhibition of return (Posner cueing paradigm). Exogenous cue-induced phasic alerting. Exogenous cue-induced phasic alerting. Sequential shifting of attention throughout the environment (visual search paradigm). Sequential shifting of attention throughout the environment (visual search paradigm). Automatic change detection (visual evoked potentials, Visual mismatch negativity). Automatic change detection (visual evoked potentials, Visual mismatch negativity). All laptop based; tested in clinical settings; simple tasks (but backed up by evidence from neuroimaging studies). All laptop based; tested in clinical settings; simple tasks (but backed up by evidence from neuroimaging studies).

Spatial Cueing Target 200, ms (a) Valid-cue trial 1000ms Cue Target 200, ms (b) Invalid-cue trial 1000ms Cue.

Phasic Alerting Target 200, ms 1000ms Cue Target 200, 400, 800 ms (b) No-cue trial(a) Double-cue trial 1000ms Cue

Visual Search Salient Not-salient

Applying this research to the study of Mild Cognitive Impairment

Phasic Alerting Target 200, ms 1000ms Cue Target 200, 400, 800 ms (b) No-cue trial(a) Double-cue trial 1000ms Cue

Phasic alerting in MCI: Results 200ms Magnitude of phasic alerting effect.

Phasic alerting: MCI converters vs non converters. Magnitude of phasic alerting effect.

Spatial Cueing Target 200, ms (a) Valid-cue trial 1000ms Cue Target 200, ms (b) Invalid-cue trial 1000ms Cue.

Spatial Cueing results 200ms 800ms

Visual Search Salient Not-salient

Visual Search Results.

Visual Mismatch Negativity

Visual Mismatch Negativity.

Visual mismatch negativity. Thick line = deviants Thin Line = standards

vMMN results: split epochs

New Study. VMMN in mild cognitive impairment. vMMN in ageing, MCI and AD. vMMN in ageing, MCI and AD. Results in MCI highly similar to those found in AD. Results in MCI highly similar to those found in AD. Implications of this finding. Implications of this finding. Differences in vMMN between individuals with AD who are receiving treatment with acetylcholinesterase inhibitors and those who are not Differences in vMMN between individuals with AD who are receiving treatment with acetylcholinesterase inhibitors and those who are not