title: Visuoperception test predicts pathologic diagnosis of Alzheimer disease in corticobasal syndrome.
abstract: OBJECTIVE
  To use the Visual Object and Space Perception Battery (VOSP) to distinguish Alzheimer disease (AD) from non-AD pathology in corticobasal syndrome (CBS).
  
  
  METHODS
  This clinicopathologic study assessed 36 patients with CBS on the VOSP. All were autopsied. The primary dependent variable was a binary pathologic outcome: patients with CBS who had primary pathologic diagnosis of AD (CBS-AD, n = 10) vs patients with CBS without primary pathologic diagnosis of AD (CBS-nonAD, n = 26). We also determined sensitivity and specificity of individual VOSP subtests.
  
  
  RESULTS
  Patients with CBS-AD had younger onset (54.5 vs 63.6 years, p = 0.001) and lower memory scores on the Mattis Dementia Rating Scale-2 (16 vs 22 points, p = 0.003). Failure on the VOSP subtests Incomplete Letters (odds ratio [OR] 11.5, p = 0.006), Position Discrimination (OR 10.86, p = 0.008), Number Location (OR 12.27, p = 0.026), and Cube Analysis (OR 45.71 p = 0.0001) had significantly greater odds of CBS-AD than CBS-nonAD. These associations remained when adjusting for total Mattis Dementia Rating score, disease laterality, education, age, and sex. Receiver operating characteristic curves demonstrated significant accuracy for Incomplete Letters and all VOSP spatial subtests, with Cube Analysis performing best (area under the curve 0.91, p = 0.0004).
  
  
  CONCLUSIONS
  In patients with CBS, failure on specific VOSP subtests is associated with greater odds of having underlying AD. There may be preferential involvement of the dorsal stream in CBS-AD.
  
  
  METHODS
  This study provides Class II evidence that some subtests of the VOSP accurately distinguish patients with CBS-AD from those without AD pathology (e.g., Cube Analysis sensitivity 100%, specificity 77%).
authors.affiliation: From the Department of Neurology (C.D.B., E.H.), Columbia University Medical Center, New York, NY; Behavioral Neurology Unit (M.T., E.M.W.), National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Pathology and Laboratory Medicine (S.S., A.L.O., B.G.), Indiana University School of Medicine, Indianapolis; and Department of Physical Medicine and Rehabilitation (J.G.), Northwestern University Feinberg School of Medicine, Chicago IL. cdboyd@fastmail.us.
authors.forename: Clara D
authors.initials: CD
authors.lastname: Boyd
authors.affiliation: From the Department of Neurology (C.D.B., E.H.), Columbia University Medical Center, New York, NY; Behavioral Neurology Unit (M.T., E.M.W.), National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Pathology and Laboratory Medicine (S.S., A.L.O., B.G.), Indiana University School of Medicine, Indianapolis; and Department of Physical Medicine and Rehabilitation (J.G.), Northwestern University Feinberg School of Medicine, Chicago IL.
authors.forename: Michael
authors.initials: M
authors.lastname: Tierney
authors.affiliation: From the Department of Neurology (C.D.B., E.H.), Columbia University Medical Center, New York, NY; Behavioral Neurology Unit (M.T., E.M.W.), National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Pathology and Laboratory Medicine (S.S., A.L.O., B.G.), Indiana University School of Medicine, Indianapolis; and Department of Physical Medicine and Rehabilitation (J.G.), Northwestern University Feinberg School of Medicine, Chicago IL.
authors.forename: Eric M
authors.initials: EM
authors.lastname: Wassermann
authors.affiliation: From the Department of Neurology (C.D.B., E.H.), Columbia University Medical Center, New York, NY; Behavioral Neurology Unit (M.T., E.M.W.), National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Pathology and Laboratory Medicine (S.S., A.L.O., B.G.), Indiana University School of Medicine, Indianapolis; and Department of Physical Medicine and Rehabilitation (J.G.), Northwestern University Feinberg School of Medicine, Chicago IL.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Spina
authors.affiliation: From the Department of Neurology (C.D.B., E.H.), Columbia University Medical Center, New York, NY; Behavioral Neurology Unit (M.T., E.M.W.), National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Pathology and Laboratory Medicine (S.S., A.L.O., B.G.), Indiana University School of Medicine, Indianapolis; and Department of Physical Medicine and Rehabilitation (J.G.), Northwestern University Feinberg School of Medicine, Chicago IL.
authors.forename: Adrian L
authors.initials: AL
authors.lastname: Oblak
authors.affiliation: From the Department of Neurology (C.D.B., E.H.), Columbia University Medical Center, New York, NY; Behavioral Neurology Unit (M.T., E.M.W.), National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Pathology and Laboratory Medicine (S.S., A.L.O., B.G.), Indiana University School of Medicine, Indianapolis; and Department of Physical Medicine and Rehabilitation (J.G.), Northwestern University Feinberg School of Medicine, Chicago IL.
authors.forename: Bernardino
authors.initials: B
authors.lastname: Ghetti
authors.affiliation: From the Department of Neurology (C.D.B., E.H.), Columbia University Medical Center, New York, NY; Behavioral Neurology Unit (M.T., E.M.W.), National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Pathology and Laboratory Medicine (S.S., A.L.O., B.G.), Indiana University School of Medicine, Indianapolis; and Department of Physical Medicine and Rehabilitation (J.G.), Northwestern University Feinberg School of Medicine, Chicago IL.
authors.forename: Jordan
authors.initials: J
authors.lastname: Grafman
authors.affiliation: From the Department of Neurology (C.D.B., E.H.), Columbia University Medical Center, New York, NY; Behavioral Neurology Unit (M.T., E.M.W.), National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Pathology and Laboratory Medicine (S.S., A.L.O., B.G.), Indiana University School of Medicine, Indianapolis; and Department of Physical Medicine and Rehabilitation (J.G.), Northwestern University Feinberg School of Medicine, Chicago IL.
authors.forename: Edward
authors.initials: E
authors.lastname: Huey
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000453:epidemiology / Q000473:pathology* / Q000503:physiopathology*; D001479:Basal Ganglia / Q000473:pathology*; D002540:Cerebral Cortex / Q000473:pathology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D014787:Vision Tests / Q000379:methods*; D014796:Visual Perception / Q000502:physiology*