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Advanced Neurology Neuroimaging regarding spatial navigation in AD

several other areas that are involved in spatial processing populations is an urgent need [150] . Despite the promising
and navigation [144] . A recent study showed that network utility of spatial navigation, the current lack of multicenter
segregation of MCI patients increased to levels similar large-scale longitudinal studies that could corroborate the
to that in cognitively intact older adults following active role of spatial navigation in the progression of the whole AD
tDCS; this finding suggests that tDCS over the right continuum is an obstacle that requires further investigation.
parietal cortex may normalize the segregation/integration In future studies, multimodal MRI in larger cohorts is needed
balance of association networks during spatial navigation to further elucidate the mechanisms by which AD pathology
in MCI patients, highlighting its potential to restore brain influences spatial navigation performance. Additionally,
activity in patients with AD [145] . The study by Suthana et al. novel spatial navigation training (e.g., immersive VR
demonstrated that DBS targeting the entorhinal cortex in training) combined with advanced technologies for early
patients with pharmacoresistant epilepsy could enhance spatial rehabilitation interventions, which could serve as
memory of spatial information during learning [146] . effective safeguarding strategies to prevent AD patients from
Collectively, neuromodulation technology showed getting lost, remains to be explored [151] .
convincing outcomes in cognition and spatial navigation
enhancement in AD treatment. Non-invasive brain Acknowledgments
stimulations could be the next AD treatment. However, None.
the lack of a standardized protocol is the current challenge
in nonpharmacological interventions. Future studies with Funding
large cohorts are warranted to determine the exact effects This work was supported by the National Science and
of neuromodulation in cognition and spatial navigation Technology Innovation 2030 - Major Program of “Brain
and to standardize the parameters, including target sites, Science and Brain-Like Research” (2022ZD0211800),
frequency, and duration of each session. the National Natural Science Foundation of China
6. Conclusions (81720108022, 81971596, 82001793), the Key Scientific
Research Project of Jiangsu Health Committee (K2019025),
In summary, spatial navigation impairment is commonly Industry and Information Technology Department of
observed in patients across the AD continuum and Nanjing (SE179-2021), Educational Research Project
is associated with different patterns of structural and of Nanjing Medical University (2019ZC036), the Project
functional alterations in the neural networks of navigation of Nanjing Health Science and Technology Development
revealed by neuroimaging, which could be attributed to (YKK19055), and funding’s for Clinical Trials from the
the pathophysiological changes in AD progression. In this Affiliated Drum Tower Hospital, Medical School of
paper, we highlight the great potential of spatial navigation Nanjing University. The funders had no role in the study
by providing novel insights into the early detection of AD design, data collection and analysis, decision to publish, or
and reviewing a more general and uniform approach toward preparation of the manuscript.
future prevention and intervention strategies for AD. More
specifically, subjects in memory clinics who complained of Conflict of interest
difficulties in everyday navigation in previously familiar
routes, accompanied by impaired navigational function, The authors report no conflicts of interest.
as demonstrated in the spatial navigation test, should Author contributions
be considered at a higher risk of incipient AD. Early
identification and intervention of incipient AD patients Conceptualization: Qian Chen
might provide a promising opportunity for a favorable Supervision: Bing Zhang
prognosis before the occurrence of substantial neuronal Writing – original draft: Qian Chen, Futao Chen, Cong
death. Furthermore, spatial navigation presents a novel Long
approach for measuring the efficacy of AD therapy across Writing – review & editing: Jiaming Lu, Jiu Chen, Jun Chen,
research sites regardless of cultural and educational Zuzana Nedelska, Jakub Hort, Bing Zhang
discrepancies [147] . Thus, it is of great value to incorporate
spatial navigation tests into standard neuropsychological Ethics approval and consent to participate
assessments in clinical settings [148,149] . Not applicable.
The development of a standardized and validated testing
system that is suitable for routine assessments of spatial Consent for publication
navigation abilities in clinical settings for various patient Not applicable.

Volume 1 Issue 2 (2022) 10 https://doi.org/10.36922/an.v1i2.145