Höffding step and beyond: The impact of visual sensory impairment on cognitive performance in neuropsychological testing of survivors of acute methanol poisoning

Article type: Research Article

Authors: Bukacova, Katerina^a | Mana, Josef^a | Zakharov, Sergey^b | Diblík, Pavel^c | Pelclova, Daniela^b | Urban, Pavel^d | Klepiš, Petr^b | Klempíř, Jiří^a | Libon, David J.^e | Růžička, Evžen^a | Bezdicek, Ondrej^{a; f; *}

Affiliations: [a] Centre of Clinical Neuroscience, Department of Neurology, First Faculty of Medicine, General University Hospital in Prague, Charles University, Prague, Czech Republic | [b] Department of Occupational Medicine, First Faculty of Medicine, General University Hospital in Prague, Charles University, Prague, Czech Republic | [c] Department of Ophthalmology, First Faculty of Medicine, General University Hospital in Prague, Charles University, Prague, Czech Republic | [d] National Institute of Public Health, Prague, Czech Republic | [e] Department of Geriatrics and Gerontology, Institute for Successful Aging, Department of Psychology, School of Osteopathic Medicine, Rowan University, Glassboro, NJ, USA | [f] Department of Psychology, Faculty of Arts, Charles University, Prague, Czech Republic

Correspondence: [*] Address for correspondence: Assoc Prof Ondrej Bezdicek, PhD, Center of Clinical Neuroscience, Department of Neurology, First Faculty of Medicine, General University Hospital, Charles University, Katerinska 30, 128 21, Prague, Czech Republic. E-mails: ondrej.bezdicek@lf1.cuni.cz and ondrej.bezdicek@gmail.com; ORCID: https://orcid.org/0000-0002-5108-0181.

Abstract: BACKGROUND:Sensory deficits can result in limitations regarding how well neuropsychological test findings can be interpreted. Only a few studies have investigated the influence of vision alteration on neuropsychological tests. In 2012 the Czech Republic experienced mass methanol poisoning. Methanol metabolites cause histotoxic hypoxia to the optic nerve. OBJECTIVE:In the current study, the effect of the toxic damage on the parts of the visual pathway on visual and non-visual neuropsychological measures was investigated using electrophysiological methods (visual evoked potential (VEP) and optical coherence tomography (OCT) with retinal nerve fibre layer (RNFL) thickness measurement. METHODS:53 individuals who experienced methanol poisoning participated in this research (76% men; ages 24 to 74 years, mean = 43.8±14.6 years; education 11.9±1.4 years). Each participant underwent comprehensive neurological, ophthalmological, and neuropsychological examinations. RESULTS:The results of mixed-effect models revealed significant small to a medium association between the Stroop test weak interference and Grooved Pegboard with the left eye global, nasal and temporal RNFL thickness. Also, medium associations between the Finger Tapping test and the Stroop test weak interference and left eye temporal RNFL, right eye temporal RNFL, and the latency P1 of VEP in the left eye were significant. CONCLUSION:The results of this study found a small to medium association (r = .15– .33; p = .010– .046) between RNFL thickness and cognitive visual test performance. Careful interpretation is suggested regarding results obtained from visual tests of the executive or motor functioning with participants with RNFL decrease or other types of early visual processing damage.

Keywords: Sensory deficit, visual impairment, neuropsychology assessment, methanol poisoning, differential diagnosis

DOI: 10.3233/NRE-220289

Journal: NeuroRehabilitation, vol. 53, no. 1, pp. 51-60, 2023