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Freehand drawing impairments in probable Alzheimer's disease

  • Murray Grossman (a1), Jenifer Mickanin (a1), Kris Onishi (a1), Keith M. Robinson (a1) and Mark D'Esposito (a1)...

Abstract

We evaluated freehand picture production of familiar objects in patients with probable Alzheimer's disease. The overall recognizability of their drawings was significantly compromised. Error analyses revealed the production of category violations and the frequent inclusion of incorrect features in a picture that were borrowed from semantically related objects, suggesting difficulty distinguishing between items with overlapping feature sets in semantic memory. Analyses of individual patient drawing profiles also revealed that some patients are disproportionately compromised in expressing a particular perceptual feature, implicating difficulty at the level of perceptual processing. Regression analyses demonstrated the contribution of limited visual attentional resources. We conclude that impaired freehand drawing in probable Alzheimer's disease is multifactorial in nature. (JINS, 1996, 2, 226–235.)

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Ajuriaguerra, J., Muller, M., & Tissot, R. (1960). A propos de quelques problemes poses par l'apraxie dans les demences. Encephale, 49, 275401.
Battig, K.A. & Montague, W.E. (1969). Category norms for verbal items in 56 categories: A replication and extension of the Connecticut category norms. Journal of Experimental Psychology Monograph, 80, 146.
Beery, K.E. & Buktenica, N.A. (1967). Developmental test of visuomotor integration. Chicago: Follett Publishing.
Brantjes, M. & Bouma, A. (1991). Qualitative analysis of the drawings of Alzheimer patients. The Clinical Neuropsychologist, 5, 4152.
Chan, A.S., Butters, N., Paulsen, J.S., Salmon, D.P., Swenson, M.R., & Maloney, L.T. (1993). An assessment of the semantic network in patients with Alzheimer's disease. Journal of Cognitive Neuroscience, 5, 254261.
Chertkow, H. & Bub, D.N. (1990). Semantic memory loss in dementia of the Alzheimer's type: What do the various measures measure? Brain, 113, 397417.
Chertkow, H., Bub, D.N., & Caplan, D. (1992). Constraining theories of semantic memory processing: Evidence from dementia. Cognitive Neuropsychology, 9, 327365.
Cronin-Golomb, A., Corkin, S., Rizzo, J.E., Cohen, J., Growdon, J.H., & Banks, K.S. (1991). Visual dysfunction in Alzheimer's disease: Relation to normal aging. Annals of Neurology, 29, 4152.
Cummings, J.L. & Benson, D.F. (1992). Dementia (2nd ed). Boston: Butterworth-Heinemann.
Desimone, R., Schein, S.J., Moran, J., & Ungerleider, L.G. (1985). Contour, color, and shape analysis beyond the striate cortex. Vision Research, 25, 441452.
Dixon, W.F. 1988. BMDP statistical manual. Berkeley, CA: University of California Press.
Fisher, L.M., Freed, D.M., & Corkin, S. (1990). Stroop colorword test performance in patients with Alzheimer's disease. Journal of Clinical and Experimental Neuropsychology, 12, 745758.
Flicker, C., Ferris, S.H., Crook, T., & Bartus, R.T. (1987). Implications of memory and language dysfunction in the naming deficit of senile dementia. Brain and Language, 31, 187200.
Flores D'Areais, G.B. & Schreuder, R. (1987). Semantic activation during object naming. Psychological Research, 49, 153159.
Folstein, M.F., Folstein, S.F., & McHugh, P.R. (1975). “Mini Mental State.” A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.
Frith, C.D., Friston, K.J., Liddle, P.F., & Frackowiak, R.S.J. (1991). A PET study of word finding. Neuropsychologia, 29, 11371148.
Grady, C.L., Haxby, J.V., Horwitz, B., Ungerleider, L.G., Schapiro, M.B., Carson, R.E., Herscovitch, P., Mishkin, M., & Rapoport, S.I. (1992). Dissociation of object and spatial vision in human extrastriate cortex: Age-related changes in activation of regional cerebral blood flow measured with 150-waterand positron emission tomography. Journal of Cognitive Neuroscience, 4, 2334.
Grober, E., Buschke, H., Kawas, C., & Fuld, P. (1985). Impaired ranking of semantic attributes in dementia. Brain and Language, 26, 276286.
Gross, C.G. (1973). Visual functions of inferotemporal cortex. In Jung, R. (Ed.) Handbook of sensory physiology (pp. 77123). New York: Springer-Verlag.
Grossman, M. (1988). Drawing deficits in brain-damaged patients’ freehand pictures. Brain and Cognition, 8, 189205.
Grossman, M. (1993). Semantic and perceptual errors in aphasics’ freehand category drawing. Neuropsychology, 7, 2740.
Grossman, M. & Carvell, S. (1993). Constructional deficits in Parkinson's disease. Neuropsychology, 7, 536547.
Grossman, M. & Mickanin, J. (1994). Picture comprehension in probable Alzheimer's disease. Brain and Cognition, 26, 4364.
Hodges, J.R., Salmon, D.P., & Butters, N. (1992). Semantic memory impairment in Alzheimer's disease: Failure of access or degraded knowledge. Neuropsychologia, 30, 301314.
Huff, F.J., Corkin, S., & Growdon, J.H. (1986). Semantic impairment and anomia in Alzheimer's disease. Brian and Language, 28, 235249.
Kempler, D., Anderson, E.S., & Henderson, V.W. (1995). Linguistic and attentional contributions to anomia in Alzheimer's disease. Neuropsychiatry, Neuropsychology, and Behavioral Neurology, 8, 3337.
Kirk, A. & Kertesz, A. (1991). On drawing impairment in Alzheimer's disease. Archives of Neurology, 48, 7377.
Lezak, M. (1983). Neuropsychological assessment. Oxford: Oxford University Press.
Martin, A. (1987). Representations of semantic and spatial knowledge in Alzheimer's disease: Implications for models of preserved learning in amnesia. Journal of Clinical and Experimental Neuropsychology, 9, 191224.
Massman, P.J., Delis, D.C., Filoteo, V., Butters, N., Salmon, D.P., & Demadura, T.L. (1993). Mechanisms of spatial impairment in Alzheimer's disease subgroups: Differential breakdown of directed attention to global-local stimuli. Neuropsychology, 7, 172181.
Mauri, A., Daum, I., Sartori, G., Riesch, G., & Birbaumer, N. (1994). Category-specific semantic impairment in Alzheimer's disease and temporal lobe dysfunction: A comparative study. Journal of Clinical and Experimental Neuropsychology, 16, 689701.
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D., & Stadian, E.M. (1984). Clinical diagnosis of Alzheimer's disease: Report on the NINCDS-ADRDA work group under the auspices of the Department of Health and Human Services Task Force on Alzheimer's disease. Neurology, 34, 939944.
Mendez, M.F., Mendez, M.A., Martin, R., Smyth, K.A., & Whitehouse, P.J. (1990). Complex visual disturbances in Alzheimer's disease. Neurology, 40, 439443.
Mickanin, J., Grossman, M., Onishi, K., Auriacombe, S., & Clark, C. (1994). Verbal and non-verbal fluency in patients with probable Alzheimer's disease. Neuropsychology, 8, 385394.
Montancs, P., Goldblum, M.C., & Boiler, F. (1995). The naming impairment of living and nonliving items in Alzheimer's disease. Journal of the International Neuropsychological Society, 1, 3948.
Moore, V. & Wyke, M.A. (1984). Drawing disability in patients with senile dementia. Psychological Medicine, 14, 97105.
Nissen, M.J., Corkin, S., Buonanno, F.S., Growdon, J.H., Wray, S.H., & Bauer, J. (1985). Spatial vision in Alzheimer's disease. Archives of Neurology, 42, 667671.
Ober, B.A., Jagust, W.J., Koss, E., Delis, D.C., & Friedland, R.P. (1991). Visuoconstructive performance and regional cerebral glucose metabolism in Alzheimer's disease. Journal of Clinical and Experimental Neuropsychology, 13, 752772.
Parasuraman, R., Greenwood, P.M., Haxby, J.V., & Grady, C.L. (1992). Visuospatial attention in dementia of the Alzheimer type. Brain, 115, 711733.
Roncato, S., Sartori, G., Masterson, J., & Rumiati, R. (1987). Constructional apraxia: An information processing analysis. Cognitive Neuropsychology, 4, 113129.
Roscn, E. (1975). Cognitive representation of semantic categories. Journal of Experimental Psychology: General, 104, 192233.
Rosen, W.G., Terry, R.D., Fuld, P.A., Katzman, R., & Peck, A. (1980). Pathological verification of ischemic score in differentiation of dementias. Annals of Neurology, 7, 486488.
Rouleau, I., Salmon, D.P., Butters, N., Kennedy, C., & McGuire, K. (1992). Quantitative and qualitative analyses of clock drawings in Alzheimer's and Huntington's disease. Brain and Cognition, 18, 7087.
Sadun, A.A., Borchert, M., Devita, E., Hinton, D.R., & Bassi, C.J. (1987). Assessment of visual impairment in patients with Alzheimer's disease. American Journal of Ophthalmology, 104, 113120.
Schreuder, R., Flores, D.Arcais, G.B., & Glazenborg, G. (1984). Effects of perceptual and conceptual similarity in semantic priming. Psychological Research, 45, 339354.
Sergent, J., Ohta, S., & MacDonald, B. (1992). Functional neuroanatomy of face and object processing: A positron emission tomography study. Brain, 115, 1536.
Shallice, T. (1988). From neuropsychology to mental structure. New York: Cambridge University Press.
Shuttleworth, E.C. & Huber, S.J. (1989). The picture absurdities test in the evaluation of dementia. Brain and Cognition, 11, 5069.
Silveri, M.C., Daniele, A., Giustolisi, L., & Gainotti, G. (1991). Dissociation between living and nonliving things in dementia of the Alzheimer type. Neurology, 41, 545546.
Sjogren, T., Sjogren, H. & Lindgren, A.G.H. (1952). Morbus Alzheimer and morbus Pick. Acta Psychiatrica et Ncurologica Scandinavica, 82, 1152.
Sunderland, T., Hill, J.L., Mellow, A.M., Lawlor, B.A., Gundersheimer, J., Newhousc, P.A., & Grafman, J.H. (1989). Clock drawing in Alzheimer's disease: A novel measure of dementia severity. Journal of the American Geriatric Society, 37, 725729.
Tippett, L.J., Grossman, M., & Farah, M.J. (in press). The semantic memory impairment of Alzheimer's disease: Category specific? Neuropsychologia.
Ungerleider, L.G. & Mishkin, M. (1982). Two cortical visual systems. In Ingle, D.J.Goodale, M.A., & Mansfield, R.J.W. (Eds.), Analysis of visual behavior (pp. 549580). Cambridge, MA: MIT Press.
Van Sommers, P. (1989). A system for drawing and drawing related neuropsychology. Cognitive Neuropsychology, 6, 117164.
Vitkovitch, M., Humphreys, G.W., & Lloyd-Jones, T.J. (1993). On naming a giraffe a zebra: Picture naming errors cross different object categories. Journal of Experimental Psychology: Learning, Memory; and Cognition, 19, 243259.
Warrington, E.K. & Shallice, T. (1984). Category-specific semantic impairments. Brain, 107, 829854.
Wechslcr, D. (1987). Wechsler memory scale—revised. San Antonio, TX: The Psychological Corporation.
Weintraub, S. & Mesulam, M.-M. (1985). Mental status assessment of young and elderly adults in behavioral neurology. In Mesulam, M.-M. (Ed.), Principles of behavioral neurology (pp. 71123). Philadelphia: F.A. Davis Company.
Wolf-Klein, G.P., Silverstone, F.A., Levy, A.P., & Brod, M.S. (1989). Screening for Alzheimer's disease by clock drawing. Journal of the American Geriatrics Society, 37, 730734.
Zeki, S., Watson, J.D.G., Lueck, C.J., Friston, K.J., Kennard, C., & Frackowiak, R.S.J. (1991). A direct demonstration of functional specialization in human visual cortex. Journal of Neuroscience, 11, 641649.

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