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Background: Mild cognitive impairment (MCI) is a common symptom in the patients with Parkinson’s disease (PD). MCI is a transitional stage between normal ageing and dementia. The neuropsychological characteristics of the PD-MCI are impairment in frontal executive function and/or visuospatial working memory. The newly modified version of the n-back test, visuospatial n-back test can assess both visuospatial recognition and visuospatial working memory. Methods: : In this study, we aimed to clarify the advantage of visuospatial n-back test as a tool for the detection of the impairment of working memory in the patients with PD. Using functional MRI, we aimed to search the specific brain regions associated with the impairment of visuospatial working memory. The score of 0-back reflects visuospatial recognition, and the scores of 1-back and 2-back reflect visuospatial working memory. We recruited 13 patients with PD-MCI, and 15 patients with cognitive normal PD (PD-CN). Group comparisons between PD-MCI and PD-CN were performed for three loads of this test. The correlations between the scores of n-back test and task-related activations were analysed for all patients. Results: : We found that the correct answer rate of patients with PD-MCI was lower in the 2-back test than those with PD-CN. However, scores of the 0-back and 1-back tests were not different between the groups. The result of fMRI showed that the activations within the middle frontal gyrus (MFG) and the inferior parietal lobule (IPL) during the 2-back test were reduced in the patients with PD-MCI. Conclusions: : This study revealed an impaired visuospatial working memory in PD-MCI in association with the reduced activations of MFG and IPL. Combinations of functional neuroimaging and the visuospatial n-back test are beneficial to evaluate the impairment of working memory in PD.
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