Highlights
- •‘Non-visual’ PCA patients present with posterior dysfunction without visual symptoms.
- •‘Non-visual’ PCA patients are less impaired than visual PCA in visuospatial/perceptual tasks.
- •Patients with ‘non-visual’ PCA and visual PCA show similar severity of apraxia.
- •Patients with ‘non-visual’ PCA show greater impairment in posterior functions than tAD.
- •Absence of clinically significant visual impairment should not exclude a diagnosis of PCA.
Abstract
Background
Early and progressive disabling visual impairment is a core feature for the diagnosis
of posterior cortical atrophy (PCA). However, some individuals that fulfil criteria
over time might initially present with an onset of prominent posterior dysfunction
other than visuoperceptual.
Methods
The clinical profile of five patients with a predominantly ‘non-visual’ posterior
presentation (PCA2) was investigated and compared with sixteen individuals with visually
predominant PCA (PCA1) and eighteen with typical amnestic Alzheimer disease (tAD).
Results
PCA2 patients showed significantly better performance than PCA1 in one visuospatial
task and were free of Balint's syndrome and visual agnosia. Compared to tAD, PCA2
showed trends towards significantly lower performance in visuoperceptual tasks, more
severe apraxia and more symptoms of Gerstmann's syndrome.
Conclusions
Our sample of PCA2 patients did not present with clinically prominent visual symptoms
but did show visual dysfunction on formal neuropsychological assessment (less pronounced
than in PCA1 but more than in tAD) in addition to other posterior deficits. Broadening
the definition of PCA to encompass individuals presenting with prominent ‘non-visual’
posterior dysfunction should be potentially considered in clinical and research contexts.
Keywords
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Article info
Publication history
Published online: May 12, 2016
Accepted:
May 11,
2016
Received in revised form:
April 13,
2016
Received:
December 14,
2015
Identification
Copyright
© 2016 Elsevier B.V. All rights reserved.
