Affiliations: Department of Medicine, Johns Hopkins University
School of Medicine, 1830 E. Monument Street, Ninth Floor, Baltimore, MD 21287,
USA | Department of Neurology, Johns Hopkins University
School of Medicine, Phipps 126; 600 N. Wolfe Street, Baltimore, MD 21287,
USA
Note: [] Corresponding author: Argye E. Hillis, M.D., Department of
Neurology, Johns Hopkins University School of Medicine, Phipps 126, 600 N.
Wolfe Street Baltimore, MD 21287, USA. Tel.: +1 410 614 2381; Fax: +1 410 614
9807; E-mail: argye@jhmi.edu
Abstract: Background: Posterior cortical atrophy (PCA) is an uncommon dementia
syndrome with initial manifestations of visual dysfunction and preservation of
memory and language until late in the disease. Since prognosis and management
differ from typical Alzheimer's disease (tAD), clinical tests to distinguish
PCA from tAD are needed. Methods: Fifteen PCA cases and 15 tAD cases, defined by clinical and
MRI criteria, were compared by present symptoms and scores on four cognitive
tests. Results: Symptoms of visual disturbance and dyslexia were more
commonly reported in PCA cases (p = 0.0001 and p = 0.006, respectively), and
memory loss was more commonly reported in tAD (p = 0.006). Patients with PCA
were less accurate on the Cortical Vision Screening Test (t = 6.0; p <
0.001) and in copying the Rey-Osterreith Complex Figure (t = 6.0; p <
0.001), in comparison to the tAD group. Memory, evaluated by the Rey Auditory
Verbal Learning Test, was impaired in both groups; however, delayed recall was
more impaired in the tAD group (t = 2.5; p = 0.03). Conclusion: Compared to patients with tAD, patients with PCA are
more likely to present to their providers with symptoms of visual dysfunction.
Performance on simple tests of visual perception and copying can be used to
distinguish the two disorders even a few years after initial symptoms.
