Posterior Cortical Atrophy: Variant of Alzheimer's Disease? A Case Series with PET Findings

Overview

Journal J Neurol

Specialty Neurology

Date 2005 Jan 18

PMID 15654552

Citations 25

Authors

Klaus Schmidtke

Michael Hull

Jochen Talazko

Affiliations

Soon will be listed here.

Abstract

Nine patients with posterior cortical atrophy (PCA), a rare degenerative brain disease of unclear etiology and nosology, were followed over a mean time of 7.4 years. The mean age at onset was low (56.2 years). At onset, eight patients had visuo-spatial and eight had memory impairment. A minority showed early signs of occipital lobe involvement with visual agnosia or hemianopia. Eight patients developed dementia after a mean course of five years. 18F-FDG-PET data of six patients were analysed with statistical parametric mapping. They showed hypometabolism centred on the lateral and medial parietal associative cortex, with variable involvement of the adjacent temporal and occipital associative cortex. A minority showed involvement of the frontal lobes, possibly related to deafferenting of areas related to the control of eye movements. Atrophy and hypometabolism were markedly asymmetric in a subset of cases. Autopsy was performed in one patient. Presenile onset, location, and asymmetry of atrophy suggest that PCA represents a biologically separable variant of Alzheimer's disease.

Citing Articles

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Progressive Compromise of Nouns and Action Verbs in Posterior Cortical Atrophy.

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References

Cambier J, Masson M, Dairou R, Henin D . [A parietal form of Pick's disease: clinical and pathological study (author's transl)]. Rev Neurol (Paris). 1981; 137(1):33-8. View

Ross S, Graham N, Prins M, Xuereb J, Patterson K, Hodges J . Progressive biparietal atrophy: an atypical presentation of Alzheimer's disease. J Neurol Neurosurg Psychiatry. 1996; 61(4):388-95. PMC: 486580. DOI: 10.1136/jnnp.61.4.388. View

LeVine D, Lee J, Fisher C . The visual variant of Alzheimer's disease: a clinicopathologic case study. Neurology. 1993; 43(2):305-13. DOI: 10.1212/wnl.43.2.305. View

Berthier M, Leiguarda R, Starkstein S, Sevlever G, Taratuto A . Alzheimer's disease in a patient with posterior cortical atrophy. J Neurol Neurosurg Psychiatry. 1991; 54(12):1110-1. PMC: 1014691. DOI: 10.1136/jnnp.54.12.1110. View

Schmidtke K, Hull M . Neuropsychological differentiation of small vessel disease, Alzheimer's disease and mixed dementia. J Neurol Sci. 2002; 203-204:17-22. DOI: 10.1016/s0022-510x(02)00254-x. View

Nestor P, Caine D, Fryer T, Clarke J, Hodges J . The topography of metabolic deficits in posterior cortical atrophy (the visual variant of Alzheimer's disease) with FDG-PET. J Neurol Neurosurg Psychiatry. 2003; 74(11):1521-9. PMC: 1738241. DOI: 10.1136/jnnp.74.11.1521. View

Mendez M, Ghajarania M, Perryman K . Posterior cortical atrophy: clinical characteristics and differences compared to Alzheimer's disease. Dement Geriatr Cogn Disord. 2002; 14(1):33-40. DOI: 10.1159/000058331. View

Wakai M, Honda H, Takahashi A, Kato T, Ito K, Hamanaka T . Unusual findings on PET study of a patient with posterior cortical atrophy. Acta Neurol Scand. 1994; 89(6):458-61. DOI: 10.1111/j.1600-0404.1994.tb02666.x. View

Hof P, Archin N, Osmand A, DOUGHERTY J, Wells C, Bouras C . Posterior cortical atrophy in Alzheimer's disease: analysis of a new case and re-evaluation of a historical report. Acta Neuropathol. 1993; 86(3):215-23. DOI: 10.1007/BF00304135. View

10.

Neumann M . Pick's disease. J Neuropathol Exp Neurol. 1949; 8(3):255-82. DOI: 10.1097/00005072-194907000-00001. View

11.

Victoroff J, Ross G, Benson D, Verity M, Vinters H . Posterior cortical atrophy. Neuropathologic correlations. Arch Neurol. 1994; 51(3):269-74. DOI: 10.1001/archneur.1994.00540150063018. View

12.

Helmer C, Joly P, Letenneur L, Commenges D, Dartigues J . Mortality with dementia: results from a French prospective community-based cohort. Am J Epidemiol. 2001; 154(7):642-8. DOI: 10.1093/aje/154.7.642. View

13.

Jacquet M, Boucquey D, Theaux R, Smidts M, CALLEWAERT A, BRUCHER J . [Posterior cortical atrophy: anatomo-clinical variant of Alzheimer's disease]. Acta Neurol Belg. 1990; 90(5):265-73. View

14.

Azouvi P, Bergego C, Robel L, Marlier N, Durand I, HELD J . Slowly progressive apraxia: two case studies. J Neurol. 1993; 240(6):347-50. DOI: 10.1007/BF00839965. View

15.

Galton C, Patterson K, Xuereb J, Hodges J . Atypical and typical presentations of Alzheimer's disease: a clinical, neuropsychological, neuroimaging and pathological study of 13 cases. Brain. 2000; 123 Pt 3:484-98. DOI: 10.1093/brain/123.3.484. View

16.

Kramer J, Miller B . Alzheimer's disease and its focal variants. Semin Neurol. 2001; 20(4):447-54. DOI: 10.1055/s-2000-13177. View

17.

Goethals M, Santens P . Posterior cortical atrophy. Two case reports and a review of the literature. Clin Neurol Neurosurg. 2001; 103(2):115-9. DOI: 10.1016/s0303-8467(01)00114-7. View

18.

Fukui T, Sugita K, Kawamura M, Shiota J, Nakano I . Primary progressive apraxia in Pick's disease: a clinicopathologic study. Neurology. 1996; 47(2):467-73. DOI: 10.1212/wnl.47.2.467. View

19.

Herholz K . FDG PET and differential diagnosis of dementia. Alzheimer Dis Assoc Disord. 1995; 9(1):6-16. DOI: 10.1097/00002093-199505000-00004. View

20.

Hof P, Bouras C, Constantinidis J, Morrison J . Balint's syndrome in Alzheimer's disease: specific disruption of the occipito-parietal visual pathway. Brain Res. 1989; 493(2):368-75. DOI: 10.1016/0006-8993(89)91173-6. View