Memory Impairment at Initial Clinical Presentation in Posterior Cortical Atrophy

Ahmed, Samrah; Baker, Ian; Thompson, Sian; Kipps, Christopher; Hornberger, Michael; Hodges, John R.; Butler, Chris

doi:10.3233/jad-160018

Cited by 27 publications

(23 citation statements)

References 20 publications

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“…Memory impairment may therefore be expected to yield poor results when used to distinguish PCA from EOAD. Our results are consistent with those of Charles and Hillis [ 9 ] and Ahmed et al [ 44 ], who found memory to be impaired in both PCA and typical AD patients. Kas et al [ 11 ], however, found that PCA patients performed better than typical AD patients on an episodic memory test, even during the early stages of PCA (≤ 3 years since onset).…”

Section: Discussionsupporting

confidence: 93%

Differentiation of neuropsychological features between posterior cortical atrophy and early onset Alzheimer’s disease

Tang

et al. 2018

BMC Neurol

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BackgroundPosterior cortical atrophy (PCA) is a group of clinical syndromes characterized by visuospatial and visuoperceptual impairment, with memory relatively preserved. Although PCA is pathologically almost identical to Alzheimer’s disease (AD), they have different cognitive features. Those differences have only rarely been reported in any Chinese population. The purpose of the study is to establish neuropsychological tests that distinguish the clinical features of PCA from early onset AD (EOAD).MethodsTwenty-one PCA patients, 20 EOAD patients, and 20 healthy controls participated in this study. Patients had disease duration of ≤4 years. All participants completed a series of neuropsychological tests to evaluate their visuospatial, visuoperceptual, visuo-constructive, language, executive function, memory, calculation, writing, and reading abilities. The cognitive features of PCA and EOAD were compared.ResultsAll the neuropsychological test scores showed that both the PCA and EOAD patients were significantly more impaired than people in the control group. However, PCA patients were significantly more impaired than EOAD patients in visuospatial, visuoperceptual, and visuo-constructive function, as well as in handwriting, and reading Chinese characters.ConclusionsThe profile of neuropsychological test results highlights cognitive features that differ between PCA and EOAD. One surprising result is that the two syndromes could be distinguished by patients’ ability to read and write Chinese characters. Tests based on these characteristics could therefore form a brief PCA neuropsychological examination that would improve the diagnosis of PCA.

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Section: Discussionsupporting

confidence: 93%

Differentiation of neuropsychological features between posterior cortical atrophy and early onset Alzheimer’s disease

Tang

et al. 2018

BMC Neurol

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“…Third, a further practical objective is to establish a common framework for cognitive screening, neuropsychological examination, and selection of cognitive outcome measures for trials involving individuals with PCA. There is a particular need for clarity regarding the evaluation of episodic memory in PCA [ 63 ]. As noted previously, memory tests with explicit visual demands in encoding and/or retrieval (e.g., Rey–Osterrieth figure copy) are unsuitable.…”

Section: Discussionmentioning

confidence: 99%

Consensus classification of posterior cortical atrophy

Crutch

Schott

Rabinovici

et al. 2017

Alzheimer's & Dementia

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IntroductionA classification framework for posterior cortical atrophy (PCA) is proposed to improve the uniformity of definition of the syndrome in a variety of research settings.MethodsConsensus statements about PCA were developed through a detailed literature review, the formation of an international multidisciplinary working party which convened on four occasions, and a Web-based quantitative survey regarding symptom frequency and the conceptualization of PCA.ResultsA three-level classification framework for PCA is described comprising both syndrome- and disease-level descriptions. Classification level 1 (PCA) defines the core clinical, cognitive, and neuroimaging features and exclusion criteria of the clinico-radiological syndrome. Classification level 2 (PCA-pure, PCA-plus) establishes whether, in addition to the core PCA syndrome, the core features of any other neurodegenerative syndromes are present. Classification level 3 (PCA attributable to AD [PCA-AD], Lewy body disease [PCA-LBD], corticobasal degeneration [PCA-CBD], prion disease [PCA-prion]) provides a more formal determination of the underlying cause of the PCA syndrome, based on available pathophysiological biomarker evidence. The issue of additional syndrome-level descriptors is discussed in relation to the challenges of defining stages of syndrome severity and characterizing phenotypic heterogeneity within the PCA spectrum.DiscussionThere was strong agreement regarding the definition of the core clinico-radiological syndrome, meaning that the current consensus statement should be regarded as a refinement, development, and extension of previous single-center PCA criteria rather than any wholesale alteration or redescription of the syndrome. The framework and terminology may facilitate the interpretation of research data across studies, be applicable across a broad range of research scenarios (e.g., behavioral interventions, pharmacological trials), and provide a foundation for future collaborative work.

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“…PCA is most commonly a visual variant of AD, but may result from dementia with Lewy bodies, Creutzfeldt-Jakob (Heidenheim variant), or other lesions or disorders involving the posterior visual cortex. PCA patients have better verbal fluency and somewhat less impaired episodic memory than typical AD, 86 and they differ from many dementias in having relatively preserved insight into their illness and a tendency to depression. Some investigators suggest that PCA is a focal Alzheimer neurodegeneration of the occipital, occipitoparietal, and occipitotemporal cortex 87,88 , and that there may be prior learning disabilities and a pre-existing vulnerability in the cortical visual systems 77 .…”

Section: Introductionmentioning

confidence: 99%

Early-Onset Alzheimer Disease

2017

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SYNOPSIS Early-onset Alzheimer’s disease (EOAD) with onset <65 years of age, while overshadowed by the more common late-onset AD (LOAD), differs significantly from LOAD. EOAD comprises about 5% of AD and is associated with delays in diagnosis, an aggressive course, and age-related psychosocial needs. One source of confusion is that a substantial percentage of EOAD are phenotypic variants that differ from the usual memory-disordered presentation of typical AD. Patients with EOAD overall have greater parietal atrophy, more white matter abnormalities, and less hippocampal volume loss, compared to those with LOAD. The phenotypic variants also have atrophy and white matter changes corresponding anatomically to the cognitive changes and appear to involve alternate neural networks relative to typical AD. The management of EOAD is similar to that for LOAD but special emphasis should be placed on targeting the specific cognitive areas involved and more age-appropriate psychosocial support and education.

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Memory Impairment at Initial Clinical Presentation in Posterior Cortical Atrophy

Cited by 27 publications

References 20 publications

Differentiation of neuropsychological features between posterior cortical atrophy and early onset Alzheimer’s disease

Differentiation of neuropsychological features between posterior cortical atrophy and early onset Alzheimer’s disease

Consensus classification of posterior cortical atrophy

Early-Onset Alzheimer Disease

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