Objective: To explore whether the Judgement of Line Orientation (JLO), VOSP Silhouettes, and VOSP Object Decision tasks distinguish performance of individuals with Parkinson’s Disease (PD) with/without visual hallucinations (VH), despite the multicultural effect on performance.

Background: Visuoperceptual deficits stemming from temporo-parietal dysfunction are thought to induce VH in PD. Indeed, individuals with PD-VH perform more poorly than PD without VH on visuoperceptual neuropsychological tests, such as JLO, Silhouettes, and Object Decision tasks. Recently, our group found these specific tests are culturally biased when comparing PD groups born in Anglosphere countries (Canada, UK, USA), where these tests were devised, versus those born elsewhere.

Method: We conducted a clinical chart review of PD patients who completed a neuropsychological assessment prior to deep brain stimulation, and divided our groups based on hallucination status (with: n=135; without: n=329) and whether individuals were born in Anglosphere (n=291) or International (n=173) countries.

Results: The Anglosphere and International groups did not differ in age, disease duration, education, sex, or proportion of patients with VH. Two-way ANOVAs for each test revealed main effects of group (Anglosphere>International) and VH status (Non-hallucinators>Hallucinators), which replicated previous findings. Importantly, we found significant interactions of VH status and group for both JLO (F(1,460)=4.02, p=0.05) and Object Decision (F(1,460)=4.02, p=0.05), but not Silhouettes (F(1,460)=.18, p=0.67). Post-hoc analyses showed that although the performance on the three tests differed as a function of VH in the Anglosphere group (all p<.001), only Silhouettes showed a significant difference between VH status in the International group (t(2.21)= 171, p=.03).

Conclusion: To conclude, cultural diversity not only impacts the general level of performance, but also the validity of two out of three measures in capturing temporo-parietal dysfunction in PD. In contrast, Silhouettes captured such dysfunction although normative data would need adjusting when used in diverse groups. Our results highlight the importance of considering cultural diversity in test selection, including tasks without a language component.
This abstract was presented but not published at the 2022 Rotman Research Institute Conference.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/do-clinical-neuropsychological-tasks-capture-visuoperceptual-deficits-in-culturally-diverse-individuals-with-parkinsons-disease-and-hallucinations/