Thesis (Ph.D.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / Parkinson's disease (PD) has traditionally been viewed as a movement disorder characterized by tremor, rigidity, akinesia, and impaired posture and gait, but more recent work documents a range of concomitant non-motor symptoms including changes in sensation, perception, and visuospatial cognition. PD subtypes are defined by characteristics of motor symptoms at disease onset, such as type of symptom (tremor, non-tremor) and body side of symptom onset, but the nature of the non-motor symptoms accompanying these subtypes is relatively unknown. The first two studies explored visual perceptual and spatial function in relation to PD subtypes. PD patients with non-tremor symptoms at onset were hypothesized to perform more poorly than those with tremor onset because of greater cortical and subcortical neuropathology. Patients with symptoms starting on the left side of the body were hypothesized to perform more poorly than right-onset patients on visuospatial functioning, reflecting hemispheric asymmetries in dopamine levels. The third study examined an intervention to counteract visual deficits relevant to activities of daily living (ADLs) in PD in general.
Study 1 used a self-report measure to identify which visual domains are most
affected in PD subtypes, as well as objective measures of visual functioning. Patients
with non-tremor onset, but not those with tremor onset, had impairments in contrast
sensitivity and specific visual ADLs. Study 2 used a standard neuropsychological
measure to assess visuospatial functioning in PD subtypes. Patients with left-side motor
symptoms at onset and non-tremor symptoms at onset performed significantly more
poorly than the control group. Study 3 examined the effect of visually-based
environmental enhancements on five instrumental ADLs in PD and control participants.
These enhancements improved performance on specific ADLs in both groups.
The present studies provided evidence for reduced contrast sensitivity, worse
visuospatial functioning, and more self-reported problems with visual ADLs in the nontremor
PD subtype than in those with tremor at onset, and worse visuospatial functioning
in patients with left than right motor symptoms at onset. Characterizing perceptual and
cognitive changes in PD subtypes provides a more complete picture of the disorder.
Future studies should focus on the relation between these changes and ADLs in PD
subtypes. / 2031-01-01
| Identifer | oai:union.ndltd.org:bu.edu/oai:open.bu.edu:2144/31598 |
| Date | January 2012 |
| Creators | Seichepine, Daniel Ryon |
| Publisher | Boston University |
| Source Sets | Boston University |
| Language | en_US |
| Detected Language | English |
| Type | Thesis/Dissertation |
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