Imagine your brain as a complex clockwork, with each cog representing a different cognitive function. In this study, we wanted to understand how mental planning works by analyzing participants’ accuracy in placing digits on a digital clock. We also explored the underlying neuropsychological factors and functional connections involved. Our hypothesis was that greater digit misplacement would be linked to attention, abstract reasoning, and visuospatial function. To investigate further, we examined the functional connectivity between a key brain region called the basal nucleus of Meynert (BNM) and other areas associated with acetylcholine activity. The results revealed fascinating associations. It turns out that command digit misplacement is closely tied to semantics, visuospatial ability, and reasoning, while also being influenced by connectivity between the BNM and the anterior cingulate cortex (ACC). Interestingly, individuals with mild cognitive impairment (MCI) showed higher levels of misplacement and diminished BNM-ACC connectivity. These findings highlight how clock drawing digit placement accuracy can serve as a valuable metric for mental planning and even shed light on neurodegenerative diseases. If you’re interested in delving deeper into this captivating research, we encourage you to explore the full article!

We examined the construct of mental planning by quantifying digital clock drawing digit placement accuracy in command and copy conditions, and by investigating its underlying neuropsychological correlates and functional connectivity. We hypothesized greater digit misplacement would associate with attention, abstract reasoning, and visuospatial function, as well as functional connectivity from a major source of acetylcholine throughout the brain: the basal nucleus of Meynert (BNM). Participants (n = 201) included non-demented older adults who completed all metrics within 24 h of one another. A participant subset met research criteria for mild cognitive impairment (MCI; n = 28) and was compared to non-MCI participants on digit misplacement accuracy and expected functional connectivity differences. Digit misplacement and a comparison dissociate variable of total completion time were acquired for command and copy conditions. a priori fMRI seeds were the bilateral BNM. Command digit misplacement is negatively associated with semantics, visuospatial, visuoconstructional, and reasoning (p’s < 0.01) and negatively associated with connectivity from the BNM to the anterior cingulate cortex (ACC; p = 0.001). Individuals with MCI had more misplacement and less BNM-ACC connectivity (p = 0.007). Total completion time involved posterior and cerebellar associations only. Findings suggest clock drawing digit placement accuracy may be a unique metric of mental planning and provide insight into neurodegenerative disease.

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