3D-real-world pointing test for spatial orientation: influences of sex and cognitive impairment on the shape configuration of mental target representation

Abstract Background Deficits in spatial memory are often early signs of neurological disorders. Here, we analyzed the geometrical configuration of 2D-projections of pointing performances to a memorized array of spatially distributed targets with respect to gender differences in healthy participants and patients with cognitive impairment. Methods 56 right-handed healthy participants (28 female, mean age 48.89 ± 19.35 years) and 22 right-handed patients with cognitive impairment (12 female, mean age 71.73 ± 7.41 years) underwent a previously validated 3D-real-world pointing test (3D-RWPT). Participants were shown a 9-dot target matrix and afterwards asked to point towards each target with closed eyes in different body positions relative to the matrix. Two-dimensional projections of these pointing vectors were then quantified using morphological analyses. Results Shape configurations in healthy volunteers largely reflected the real-world target pattern with gender-dependent differences (ANCOVA area difference male/female = 38350.43, pbonf=3.69x10− 3**). Patients with cognitive impairment showed impaired rectangularity and made more large-scale errors, resulting in decreased overall average diameters and solidity (ANCOVA diameter difference normal cognition/cognitive impairment = 31.22, pbonf=3.19x10− 3**; solidity difference = 0.07, pbonf=6.76x10− 3**). Conclusion Shape configuration analysis of the 3D-RWPT target set by morphological properties appears to be a suitable holistic measure of spatial performance, differentiating sex effects and cognitive impairment when analyzed by group- and paradigm-wise averages.