Diagnostic evaluation and monitoring of patients with posterior cortical atrophy

Neurodegener Dis Manag. 2019 Aug;9(4):217-239. doi: 10.2217/nmt-2018-0052. Epub 2019 Aug 8.

Abstract

Posterior cortical atrophy (PCA) is a progressive neurocognitive syndrome, most commonly associated with the loss of complex visuospatial functions. Diagnosis is challenging, and international consensus classification and nomenclature for PCA subtypes have only recently been reached. Presently, no established treatments exist. Efforts to develop treatments are hampered by the lack of standardized methods to monitor illness progression. Although measures developed from work with Alzheimer's disease and other dementias provide a foundation for diagnosing and monitoring progression, PCA presents unique challenges for clinicians counseling patients and families on clinical status and prognosis, and experts designing clinical trials of interventions. Here, we review issues facing PCA clinical research and care, summarize our approach to diagnosis and monitoring of disease progression, and outline ideas for developing tools for these purposes.

Keywords: Alzheimer’s disease; MRI; biomarkers; cerebral cortex; clinical trials; neuropsychology; positron emission tomography; posterior cortical atrophy.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Age of Onset
  • Aged
  • Alzheimer Disease / classification
  • Alzheimer Disease / diagnosis
  • Atrophy
  • Cognition Disorders / etiology
  • Cognitive Dysfunction / diagnosis
  • Dementia / complications
  • Dementia / diagnosis*
  • Dementia / pathology
  • Dementia / rehabilitation
  • Diagnosis, Differential
  • Disease Management
  • Disease Progression
  • Executive Function
  • Female
  • Genetic Predisposition to Disease
  • Humans
  • Language Disorders / etiology
  • Male
  • Memory Disorders / etiology
  • Mental Status and Dementia Tests
  • Middle Aged
  • Neuroimaging
  • Occipital Lobe / pathology*
  • Occipital Lobe / physiopathology
  • Perceptual Disorders / etiology*
  • Psychomotor Disorders / etiology
  • Severity of Illness Index
  • Vision Disorders / etiology*
  • Visual Perception