ArticleFrontiers in aging neuroscience2026
Route efficiency in spatial navigation as an early indicator of cognitive decline in amnestic mild cognitive impairment.
Article in Frontiers in aging neuroscience, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: The hippocampus is one of the brain regions most affected by neurodegeneration in Alzheimer's disease (AD). This structure and its neural circuits are critically involved in spatial learning and memory. Poor spatial navigation performance in virtual environments such as the Virtual Morris Water Navigation Task (VMWNT) may precede other clinical findings in amnestic mild cognitive impairment (aMCI), a pre-dementia stage of AD. To explore this idea, we correlated aMCI and cognitively healthy control (HC) performance in the VMWNT with Montreal Cognitive Assessment (MoCA) and Memory Index Score (MoCA-MIS), testing whether navigation-derived metrics are associated with cognitive performance within a framework of shared medial temporal lobe vulnerability. Methods: Thirty-eight participants (18 aMCI, 20 HC) were assessed for neurologic evaluation and VMWNT performance. Neuropsychological tests, including MoCA, MoCA-MIS, Clinical Dementia Rating (CDR), CDR sum of boxes (CDR-SOB) and AD8, were performed. Group differences were assessed using Mann-Whitney U tests on participant-level means and complemented with mixed-effects models to account for the repeated-measures structure of trial-level data. All behavioral parameters obtained in the VMWNT were reduced to a single variable, "Route Efficiency," through Principal Component Analysis (PCA) on five navigation variables, with the aim to correlate spatial memory performance with clinical findings. Results: Significant differences in VMWNT performance were observed. aMCI patients displayed longer path lengths ( Discussion: Group differences in Route Efficiency and correlations with cognitive measures were observed, though these associations primarily reflected between-group rather than individual variation. Allocentric significant findings were not observed. These preliminary results support further exploration of virtual navigation paradigms in clinical settings.
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