Clinical Screening for Posterior Cortical Atrophy

IF 1.3 4区 医学 Q4 BEHAVIORAL SCIENCES Cognitive and Behavioral Neurology Pub Date : 2022-06-01 DOI:10.1097/WNN.0000000000000297
M. Mendez, Youssef I. Khattab, Oleg Yerstein
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引用次数: 1

Abstract

Background: Posterior cortical atrophy (PCA) is a progressive neurologic syndrome that presents with complex visual deficits. Although PCA is most commonly a form of Alzheimer disease (AD), its early diagnosis is usually delayed due to a lack of understanding for how best to clinically screen for the syndrome. Objective: To identify neurobehavioral screening tasks for PCA—beyond simple visual constructions—that can be administered in clinic or at bedside. Method: We compared the performance of 12 individuals who met neuroimaging-supported consensus criteria for PCA with that of 12 matched individuals with typical AD (tAD) and 24 healthy controls (HC) on clinic/bedside tasks measuring (a) complex figure copying, (b) Balint syndrome, (c) visual object agnosia, (d) color identification, (e) figure–ground discrimination, (f) global–local processing, (g) dressing apraxia, (h) ideomotor apraxia, and (i) Gerstmann syndrome. Results: All of the individuals with PCA were impaired on the figure–ground discrimination task compared with half of the tAD group and no HC. Approximately half of the PCA group had Balint syndrome, dressing apraxia, and ideomotor apraxia compared with none in the tAD group. Difficulty copying a complex figure, global–local processing impairment, and Gerstmann syndrome did not distinguish between the two dementia groups. Conclusion: The figure–ground discrimination task can be used successfully as an overall screening measure for PCA, followed by specific tasks for Balint syndrome and dressing and limb apraxia. Findings reinforce PCA as a predominant occipitoparietal disorder with dorsal visual stream involvement and parietal signs with spatiomotor impairments.
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后皮质萎缩的临床筛查
背景:后皮质萎缩(PCA)是一种进行性神经系统综合征,表现为复杂的视觉缺陷。虽然PCA是最常见的阿尔茨海默病(AD)的一种形式,但由于缺乏对如何最好地临床筛查该综合征的了解,其早期诊断通常会延迟。目的:确定可在临床或床边实施的pca的神经行为筛查任务,而不是简单的视觉结构。方法:我们比较了12名符合神经影像学支持的PCA共识标准的个体与12名匹配的典型AD (tAD)个体和24名健康对照(HC)在临床/床边任务中的表现(a)复杂图形复制,(b) Balint综合征,(c)视觉对象失认症,(d)颜色识别,(e)图形-背景辨别,(f)全局-局部处理,(g)穿衣失用症,(h)意念运动失用症,以及(i) Gerstmann综合征。结果:所有PCA患者在图-底辨别任务上均受损,而一半的tAD组和无HC组。大约一半的PCA组有Balint综合征、穿衣失用症和意念运动失用症,而tAD组没有。复制复杂图形困难、整体-局部处理障碍和Gerstmann综合征并不能区分两组痴呆患者。结论:图-底辨别任务可以成功地作为PCA的整体筛查措施,其次是Balint综合征和穿衣肢体失用症的具体筛查任务。研究结果表明,PCA是一种主要的枕顶叶疾病,伴有背视流受累和空间运动障碍的顶叶症状。
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来源期刊
CiteScore
2.40
自引率
7.10%
发文量
68
审稿时长
>12 weeks
期刊介绍: Cognitive and Behavioral Neurology (CBN) is a forum for advances in the neurologic understanding and possible treatment of human disorders that affect thinking, learning, memory, communication, and behavior. As an incubator for innovations in these fields, CBN helps transform theory into practice. The journal serves clinical research, patient care, education, and professional advancement. The journal welcomes contributions from neurology, cognitive neuroscience, neuropsychology, neuropsychiatry, and other relevant fields. The editors particularly encourage review articles (including reviews of clinical practice), experimental and observational case reports, instructional articles for interested students and professionals in other fields, and innovative articles that do not fit neatly into any category. Also welcome are therapeutic trials and other experimental and observational studies, brief reports, first-person accounts of neurologic experiences, position papers, hypotheses, opinion papers, commentaries, historical perspectives, and book reviews.
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