E analyzed from a descriptive point of view. The chi-square test was used to identify possible differences in the sex distribution between the two groups. We used a nonparametric test (MannWhitney) to compare 1317923 the results of neuropsychological tests and toVisuospatial Function in Early Alzheimer’s DiseaseTable 2. The scores of the control subjects and AD patients on the neuropsychological assessment tests.Controls Mean (SD) RAVLT – total RAVLT – after interference RAVLT – after 30 minutes Raven – colored Autophagy version Verbal Fluency – animals Rey Complex Figure – copy Rey Complex Figure – immediate recall Rey Complex Figure – delayed recall Clock Epigenetic Reader Domain Drawing test Corsi – direct (span) Corsi – inverse (span) Boston Naming (15 items) Cancellation task (number correct) Cancellation task (number of errors) Cancellation task (time in seconds) *Mann-Whitney test. doi:10.1371/journal.pone.0068398.t002 40.91 (8.73) 8.02 (3.20) 7.00 (3.27) 26.25 (6.89) 17.00 (4.45) 32.56 (4.03) 16.38 (5.96) 19.49 (7.92) 8.41 (2.11) 4.93 (1.13) 4.48 (1.07) 14.41 (0.84) 49.82 (8.85) 0.41 (1.04) 161.27 (60.18)Mild AD Patients Mean (SD) 24.48 (5.87) 2.19 (2.06) 0.90 (1.40) 18.52 (5.46) 10.87 (3.71) 25.95 (8.04) 5.98 (5.50) 4.92 (6.42) 6.35 (2.59) 3.71 (1.58) 4.15 (1.22) 12.19 (1.94) 40.19 (1.29) 2.35 (4.05) 246.13 (48.42) p-value * ,0.001 ,0.001 ,0.001 ,0.001 ,0.001 ,0.001 ,0.001 ,0.001 ,0.01 ,0.001 0.012 ,0.001 0.001 0.009 ,0.The scores on the space perception tests revealed a significant difference between the groups on the Number Location and Cube Analysis subtests. Conversely, the results of the Dot Counting and Position Discrimination subtests were not significantly different (p = 0.252, p = 0.120, respectively). We used ROC curve analysis to differentiate the AD patients from the controls using the cutoff points (area under the curve) and the sensitivity and specificity for each variable of interest. Analyzing the data in Table 4, we could observe the cutoff scores, sensitivity, and specificity for the subtests of the VOSP battery. All of the subtests in which it was observed a statistically significant difference between the AD and control subjects (except Dot Counting and Position Discrimination) showed a good ability to discriminate between the two groups. The Spearman correlation was used to investigate the association between the neuropsychological tests that had visuospatial and perceptive components and the VOSP subtests. TheShape Detection score correlated with the results of the MMSE (r = 0.317), both of which were used as screening tests (Table 5). All of the subtests that assessed object perception and two space perception subtests (Number Location and Cube Analysis) correlated significantly with the Raven’s test and Boston Naming Test scores. All of these tests require significant visual-perception ability. The Number Location subtest demonstrated a correlation with the Corsi Block Direct test (r = 0.600); both of these tests require space-perception skill.DiscussionIn this study, it was assessed visuospatial function in early-stage of AD using the VOSP battery, which aims to assess these functions specifically by eliminating the interference of other cognitive functions.Table 3. Comparison between the AD patients and healthy elderly controls in each VOSP subtest.Controls Mean (SD) Screening Object Perception Shape Detection Incomplete Letters Silhouettes Object Decision Progressive Silhouettes Space Perception Dot Counting Position Discrimination Number Loca.E analyzed from a descriptive point of view. The chi-square test was used to identify possible differences in the sex distribution between the two groups. We used a nonparametric test (MannWhitney) to compare 1317923 the results of neuropsychological tests and toVisuospatial Function in Early Alzheimer’s DiseaseTable 2. The scores of the control subjects and AD patients on the neuropsychological assessment tests.Controls Mean (SD) RAVLT – total RAVLT – after interference RAVLT – after 30 minutes Raven – colored version Verbal Fluency – animals Rey Complex Figure – copy Rey Complex Figure – immediate recall Rey Complex Figure – delayed recall Clock Drawing test Corsi – direct (span) Corsi – inverse (span) Boston Naming (15 items) Cancellation task (number correct) Cancellation task (number of errors) Cancellation task (time in seconds) *Mann-Whitney test. doi:10.1371/journal.pone.0068398.t002 40.91 (8.73) 8.02 (3.20) 7.00 (3.27) 26.25 (6.89) 17.00 (4.45) 32.56 (4.03) 16.38 (5.96) 19.49 (7.92) 8.41 (2.11) 4.93 (1.13) 4.48 (1.07) 14.41 (0.84) 49.82 (8.85) 0.41 (1.04) 161.27 (60.18)Mild AD Patients Mean (SD) 24.48 (5.87) 2.19 (2.06) 0.90 (1.40) 18.52 (5.46) 10.87 (3.71) 25.95 (8.04) 5.98 (5.50) 4.92 (6.42) 6.35 (2.59) 3.71 (1.58) 4.15 (1.22) 12.19 (1.94) 40.19 (1.29) 2.35 (4.05) 246.13 (48.42) p-value * ,0.001 ,0.001 ,0.001 ,0.001 ,0.001 ,0.001 ,0.001 ,0.001 ,0.01 ,0.001 0.012 ,0.001 0.001 0.009 ,0.The scores on the space perception tests revealed a significant difference between the groups on the Number Location and Cube Analysis subtests. Conversely, the results of the Dot Counting and Position Discrimination subtests were not significantly different (p = 0.252, p = 0.120, respectively). We used ROC curve analysis to differentiate the AD patients from the controls using the cutoff points (area under the curve) and the sensitivity and specificity for each variable of interest. Analyzing the data in Table 4, we could observe the cutoff scores, sensitivity, and specificity for the subtests of the VOSP battery. All of the subtests in which it was observed a statistically significant difference between the AD and control subjects (except Dot Counting and Position Discrimination) showed a good ability to discriminate between the two groups. The Spearman correlation was used to investigate the association between the neuropsychological tests that had visuospatial and perceptive components and the VOSP subtests. TheShape Detection score correlated with the results of the MMSE (r = 0.317), both of which were used as screening tests (Table 5). All of the subtests that assessed object perception and two space perception subtests (Number Location and Cube Analysis) correlated significantly with the Raven’s test and Boston Naming Test scores. All of these tests require significant visual-perception ability. The Number Location subtest demonstrated a correlation with the Corsi Block Direct test (r = 0.600); both of these tests require space-perception skill.DiscussionIn this study, it was assessed visuospatial function in early-stage of AD using the VOSP battery, which aims to assess these functions specifically by eliminating the interference of other cognitive functions.Table 3. Comparison between the AD patients and healthy elderly controls in each VOSP subtest.Controls Mean (SD) Screening Object Perception Shape Detection Incomplete Letters Silhouettes Object Decision Progressive Silhouettes Space Perception Dot Counting Position Discrimination Number Loca.
