title: Memory Impairment at Initial Clinical Presentation in Posterior Cortical Atrophy.
abstract: Posterior cortical atrophy (PCA) is characterized by core visuospatial and visuoperceptual deficits, and predominant atrophy in the parieto-occipital cortex. The most common underlying pathology is Alzheimer's disease (AD). Existing diagnostic criteria suggest that episodic memory is relatively preserved. The aim of this study was to examine memory performance at initial clinical presentation in PCA, compared to early-onset AD patients (EOAD). 15 PCA patients and 32 EOAD patients, and 34 healthy controls were entered into the study. Patients were tested on the Addenbrooke's Cognitive Examination (ACE-R), consisting of subscales in memory and visuospatial skills. PCA and EOAD patients were significantly impaired compared to controls on the ACE total score (p < 0.001), visuospatial skills (p < 0.001), and memory (p < 0.001). Consistent with the salient diagnostic deficits, PCA patients were significantly more impaired on visuospatial skills compared to EOAD patients (p < 0.001). However, there was no significant difference between patient groups in memory. Further analysis of learning, recall, and recognition components of the memory subscale showed that EOAD and PCA patients were significantly impaired compared to controls on all three components (p < 0.001), however, there was no significant difference between EOAD and PCA patients. The results of this study show that memory is impaired in the majority of PCA patients at clinical presentation. The findings suggest that memory impairment must be considered in assessment and management of PCA. Further study into memory in PCA is warranted, since the ACE-R is a brief screening tool and is likely to underestimate the presence of memory impairment.
authors.affiliation: Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UK.
authors.forename: Samrah
authors.initials: S
authors.lastname: Ahmed
authors.affiliation: Russell Cairns Unit, Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Oxford, UK.
authors.forename: Ian
authors.initials: I
authors.lastname: Baker
authors.affiliation: Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UK.|Department of Experimental Psychology, University of Oxford, John Radcliffe Hospital, Oxford, UK.
authors.forename: Masud
authors.initials: M
authors.lastname: Husain
authors.affiliation: Department of Clinical Neurology, Oxford University Hospitals NHS Trust, Oxford, UK.
authors.forename: Sian
authors.initials: S
authors.lastname: Thompson
authors.affiliation: Wessex Neurological Centre, University Hospitals Southampton NHS Foundation Trust and University of Southampton and Wessex Collaboration for Leadership in Applied Health Research and Care (CLAHRC), Southampton, UK.
authors.forename: Christopher
authors.initials: C
authors.lastname: Kipps
authors.affiliation: Norwich Medical School, University of East Anglia, Norwich, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Hornberger
authors.affiliation: Neuroscience Research Australia and University of New South Wales, Sydney, Australia.
authors.forename: John R
authors.initials: JR
authors.lastname: Hodges
authors.affiliation: Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UK.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Butler
mesh_terms: D000544:Alzheimer Disease / Q000175:diagnosis / Q000473:pathology*; D001284:Atrophy; D002540:Cerebral Cortex / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000473:pathology*; D008875:Middle Aged; D009483:Neuropsychological Tests; D009778:Occipital Lobe / Q000473:pathology; D010296:Parietal Lobe / Q000473:pathology
keywords: Diagnosis; early onset Alzheimer’s disease; memory; neuropsychology