Attention impairment in people with Parkinson– related Pisa Syndrome

Background and Aims: Pisa Syndrome (PS) is a disabling postural deformity, with a strong impact on life quality of people with Parkinson’s disease (pwPD). However, it can be reversible if diagnosed and treated at an early stage. Our purpose is to analyze PS from a different perspective: the ocular behavior, through the Eye Tracking methodology. Our goal is to shed light on the association between PS and the deficit of the visuospatial and attentive functions, as explored by the Eye Tracking approach, looking into clinical predictors of reduced visuospatial abilities and inferring on the need for adapting the rehabilitation approach. Methods: This cross sectional study, comparing behavior reactions and pattern of visual scanning in a group of pwPD – with (PS+) or without (PS-) trunk postural deviation - and a group of healthy age-matched people (HC), was held using the eye tracker EyeLink 1000. The Benton Judgment of Line Orientation Test was used to create a set of stimuli consecutively presented on the screen, while tracking patients’ gaze. Results: PS+ show a deficit of visuospatial functions, attention distribution and a reduced awareness of their posture. Neuropsychological features correlate with the pattern of visual scanning, which is significantly different in PS+ from PS- and HC. Attention impairment significantly impacts patients’ performance on the Benton test. Conclusions: Visuospatial ability impairment should be taken into account when planning the rehabilitation approach to postural abnormalities in pwPD