Prodromal posterior cortical atrophy: clinical, neuropsychological, and radiological correlation

Abstract

We present longitudinal clinical, cognitive, and neuroimaging data from a 63-year-old woman who enrolled in research as a normal control and evolved posterior cortical atrophy (PCA) over 5 year follow-up. At baseline she reported only subtle difficulty driving and performed normally on cognitive tests, but already demonstrated atrophy in left visual association cortex. With follow-up she developed insidiously progressive visuospatial and visuoperceptual deficits, correlating with progressive atrophy in bilateral visual areas. Amyloid PET was positive. This case tracks the evolution of PCA from the prodromal stage, and illustrates challenges to early diagnosis as well as the utility of imaging biomarkers.

Keywords:

• posterior cortical atrophy
• atypical Alzheimer's disease
• VBM
• PET
• neuropsychology

Acknowledgments

The authors would like to thank Dr. Michael W. Weiner for MRI imaging and Dr. William Jagust for PET imaging.