Visuospatial impairment in Parkinson's Disease: why we should keep an eye on it.

Abstract

Visuospatial dysfunction is a common yet underappreciated non-motor manifestation of Parkinson's disease (PD) that significantly impacts quality of life and predicts cognitive deterioration. While motor symptoms have long dominated the clinical landscape, accumulating evidence highlights that deficits in visuospatial processing can emerge even in cognitively intact individuals and frequently worsen as the disease progresses to mild cognitive impairment and dementia. This review synthesizes evidence from neuropsychological, neuroimaging, and clinical studies to illustrate the widespread prevalence and prognostic importance of visuospatial dysfunction in PD. We discuss the limitations of current screening tools, the diagnostic utility of specific tests, and the underlying neural mechanisms involving visuospatial dysfunction. Beyond diagnosis, we emphasize the functional consequences of visuospatial deficits, including increased fall risk, impaired navigation, and loss of autonomy. Finally, we call for the systematic integration of visuospatial assessment in clinical practice and research, as well as the development of accessible, ecologically valid, and technologically advanced tools to better address this pivotal domain.