Progressive impairment of constructional abilities: a visuospatial sketchpad deficit?

The case of a patient, PC, with an impairment of constructional abilities due to a progressive degenerative disease is described. Ideomotor apraxia was also present. PC showed difficulties in all tasks requiring a "manipulation" of a visual model or requiring a visual model to address a specific movement or a choice among alternatives. The spatial component of mental imagery was also severely impaired. The conclusion was that the patient presented a deficit of the rehearsal component of the visuospatial sketchpad (VSSP). This produced an impairment of spatial learning, but spatial retrograde memory was preserved, as well as object recognition. The most prominent sites of atrophy were located in the parietal lobe bilaterally. A 3-year follow-up is reported, showing a progressive impairment of verbal abilities.