Posterior cortical atrophy: Clinical, neuroimaging and neuropsychological features

Abstract

Posterior cortical atrophy (PCA) represents a rare variant of degenerative dementia, predominantly marked by visuospatial deficits and cognitive impairment. The diagnostic complexity consist of atypical symptoms at onset and non-specific neuroimaging findings. In this retrospective case study, we investigated clinical, neuropsychological, and imaging aspects in five cases with pure PCA. 754 patients who presented to the dementia outpatient clinic of Çukurova University Faculty of Medicine Neurology Department between 2013-2022 were retrospectively analyzed, and 5 cases diagnosed with PCA were included in the study. Mini-Mental State Examination (MMSE), clock drawing test (CDT), cookie thief test, simultanognosy tests (Arcimboldo pictures, Navon letters), and imaging findings of the cases were documented. The average age of the subjects was 60.6 years, with an onset typically occurring at a presenile stage. Simultanagnosia was a consistent finding in all patients, with some exhibiting additional visuospatial deficits. Mini-Mental State Examination (MMSE) scores averaged 20.20, and clock drawing test results indicated impairment. Notably, 40% of the patients displayed depressive symptoms, often alongside visual complaints as a common presentation. Crucially, all patients retained speech fluency. Our findings underscore the significance of employing neurocognitive assessments, particularly the clock drawing test, when evaluating patients with complaints related to visuospatial and cognitive functions. Early diagnosis and intervention are pivotal for effectively managing PCA.

Keywords

• Posterior cortical atrophy
• Simultanognosia
• clock drawing test
• dementia

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