1
|
Volkmer A, Cross L, Highton L, Jackson C, Smith C, Brotherhood E, Harding EV, Mummery C, Rohrer J, Weil R, Yong K, Crutch S, Hardy CJD. 'Communication is difficult': Speech, language and communication needs of people with young onset or rarer forms of non-language led dementia. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2024; 59:1553-1577. [PMID: 38329409 DOI: 10.1111/1460-6984.13018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 01/17/2024] [Indexed: 02/09/2024]
Abstract
BACKGROUND People with behavioural variant frontotemporal dementia, Lewy body dementia, posterior cortical atrophy and young onset Alzheimer's disease may experience language and communication difficulties. However, the role of speech and language interventions for people with these non-language led dementias has received little attention. AIMS This study aimed to explore the experiences and perspectives of people living with these conditions, and their families, regarding their language and communication difficulties and how speech and language therapy could address these needs. METHODS This study employed a qualitative design to explore the experiences of people living with or caring for somebody with behavioural variant frontotemporal dementia, Lewy body dementia, posterior cortical atrophy or young onset Alzheimer's disease, and to understand their opinions about speech and language therapy. Participants were recruited from a support service connected to a dementia clinic to attend one of five focus group meetings. Videorecorded focus groups and interviews were transcribed, and reflexive thematic analysis was used to analyse data from people affected by each type of dementia. RESULTS A total of 25 participants were recruited to the study, with representation across the different forms of non-language led dementias. The four main themes identified were: (1) communication difficulties as a key difficulty, (2) loss and loneliness, (3) speech and language therapy, and (4) the role of the caregiver. Sixteen subthemes were also identified which highlighted individual issues across disease types. DISCUSSION Although all the forms of dementia studied here are not considered to be language-led, people with these conditions and/or their care partners identified speech, language and communication as common challenges. These communication difficulties were reported to have a negative impact on their social participation and mental health and participants felt speech and language interventions could help. There is a need for research exploring speech and language interventions developed for and with people with non-language led dementias and their care partners, to ensure they meet the needs of the people they are designed for. WHAT THIS PAPER ADDS What is already known on the subject People with primary progressive aphasia present with speech, language and communication difficulties, and several speech and language interventions have been developed to meet the needs of this population. However, people with non-language led dementias may also experience speech, language and communication difficulties, and little is known about interventions that may address these difficulties. What this paper adds to existing knowledge People living with or caring for somebody with behavioural variant frontotemporal dementia, Lewy body dementia, posterior cortical atrophy and young onset Alzheimer's disease report experiencing speech, language and communication difficulties that impact on the person with dementia's social participation and mood. Participants in this study also shared their opinions about how speech and language interventions could help, from the earliest stages of the disease. What are the potential or actual clinical implications of this work? Speech and language therapists need to address the individual speech, language and communication needs of people with dementias, even those that are not thought to be language-led. Current speech and language therapy service provision does not meet the needs of people with non-language led dementias and further research is required to develop interventions and services to meet these needs.
Collapse
Affiliation(s)
- Anna Volkmer
- Psychology and Language Sciences, University College London, London, UK
| | - Lisa Cross
- Psychology and Language Sciences, University College London, London, UK
- King's College Hospital NHS Foundation Trust, London, UK
| | - Lily Highton
- Psychology and Language Sciences, University College London, London, UK
- Whittington Health NHS Trust, London, UK
| | - Connie Jackson
- Psychology and Language Sciences, University College London, London, UK
- Guys and St Thomas' NHS Foundation Trust, London, UK
| | - Chloe Smith
- Psychology and Language Sciences, University College London, London, UK
- Guys and St Thomas' NHS Foundation Trust, London, UK
| | - Emilie Brotherhood
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Emma V Harding
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Cath Mummery
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Jonathan Rohrer
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Rimona Weil
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Keir Yong
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Sebastian Crutch
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Chris J D Hardy
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| |
Collapse
|
2
|
Cutler J, Bodet A, Rivest J, Cavanagh P. The word superiority effect overcomes crowding. Vision Res 2024; 222:108436. [PMID: 38820621 DOI: 10.1016/j.visres.2024.108436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 05/14/2024] [Accepted: 05/14/2024] [Indexed: 06/02/2024]
Abstract
Crowding and the word superiority effect are two perceptual phenomena that influence reading. The identification of the inner letters of a word can be hindered by crowding from adjacent letters, but it can be facilitated by the word context itself (the word superiority effect). In the present study, strings of four-letters (words and non-words) with different inter-letter spacings (ranging from an optimal spacing to produce crowding to a spacing too large to produce crowding) were presented briefly in the periphery and participants were asked to identify the third letter of the string. Each word had a partner word that was identical except for its third letter (e.g., COLD, CORD) so that guessing as the source of the improved performance for words could be ruled out. Unsurprisingly, letter identification accuracy for words was better than non-words. For non-words, it was lowest at closer spacings, confirming crowding. However, for words, accuracy remained high at all inter-letter spacings showing that crowding did not prevent identification of the inner letters. This result supports models of "holistic" word recognition where partial cues can lead to recognition without first identifying individual letters. Once the word is recognized, its inner letters can be recovered, despite their feature loss produced by crowding.
Collapse
Affiliation(s)
- June Cutler
- Department of Psychology, Glendon College, York University, Toronto, ON, M4N 3M6, Canada
| | - Alexandre Bodet
- Department of Psychology, Glendon College, York University, Toronto, ON, M4N 3M6, Canada
| | - Josée Rivest
- Department of Psychology, Glendon College, York University, Toronto, ON, M4N 3M6, Canada; Centre for Vision Research, York University, Toronto, ON, M3J 1P3, Canada.
| | - Patrick Cavanagh
- Department of Psychology, Glendon College, York University, Toronto, ON, M4N 3M6, Canada; Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH 03755, USA; Centre for Vision Research, York University, Toronto, ON, M3J 1P3, Canada
| |
Collapse
|
3
|
Yong KXX, Graff-Radford J, Ahmed S, Chapleau M, Ossenkoppele R, Putcha D, Rabinovici GD, Suarez-Gonzalez A, Schott JM, Crutch S, Harding E. Diagnosis and Management of Posterior Cortical Atrophy. Curr Treat Options Neurol 2023; 25:23-43. [PMID: 36820004 PMCID: PMC9935654 DOI: 10.1007/s11940-022-00745-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2022] [Indexed: 02/10/2023]
Abstract
Purpose of review The study aims to provide a summary of recent developments for diagnosing and managing posterior cortical atrophy (PCA). We present current efforts to improve PCA characterisation and recommendations regarding use of clinical, neuropsychological and biomarker methods in PCA diagnosis and management and highlight current knowledge gaps. Recent findings Recent multi-centre consensus recommendations provide PCA criteria with implications for different management strategies (e.g. targeting clinical features and/or disease). Studies emphasise the preponderance of primary or co-existing Alzheimer's disease (AD) pathology underpinning PCA. Evidence of approaches to manage PCA symptoms is largely derived from small studies. Summary PCA diagnosis is frequently delayed, and people are likely to receive misdiagnoses of ocular or psychological conditions. Current treatment of PCA is symptomatic - pharmacological and non-pharmacological - and the use of most treatment options is based on small studies or expert opinion. Recommendations for non-pharmacological approaches include interdisciplinary management tailored to the PCA clinical profile - visual-spatial - rather than memory-led, predominantly young onset - and psychosocial implications. Whilst emerging disease-modifying treatments have not been tested in PCA, an accurate and timely diagnosis of PCA and determining underlying pathology is of increasing importance in the advent of disease-modifying therapies for AD and other albeit rare causes of PCA.
Collapse
Affiliation(s)
- Keir X. X. Yong
- Dementia Research Centre, UCL Queen Square Institute of Neurology, Box 16, Queen Square, London, WC1N 3BG UK
| | | | - Samrah Ahmed
- Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, UK
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, Berkshire UK
| | - Marianne Chapleau
- Memory and Aging Center, University of California San Francisco, San Francisco, CA USA
| | - Rik Ossenkoppele
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, Amsterdam, Netherlands
- Clinical Memory Research Unit, Lund University, Lund, Sweden
| | - Deepti Putcha
- Frontotemporal Disorders Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA USA
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA USA
| | - Gil D. Rabinovici
- Department of Neurology, Radiology, and Biomedical Imaging, University of California San Francisco, San Francisco, CA USA
| | - Aida Suarez-Gonzalez
- Dementia Research Centre, UCL Queen Square Institute of Neurology, Box 16, Queen Square, London, WC1N 3BG UK
| | - Jonathan M. Schott
- Dementia Research Centre, UCL Queen Square Institute of Neurology, Box 16, Queen Square, London, WC1N 3BG UK
| | - Sebastian Crutch
- Dementia Research Centre, UCL Queen Square Institute of Neurology, Box 16, Queen Square, London, WC1N 3BG UK
| | - Emma Harding
- Dementia Research Centre, UCL Queen Square Institute of Neurology, Box 16, Queen Square, London, WC1N 3BG UK
| |
Collapse
|
4
|
Pelak VS, Mahmood A, Abe-Ridgway K. Perspectives and a Systematic Scoping Review on Longitudinal Profiles of Posterior Cortical Atrophy Syndrome. Curr Neurol Neurosci Rep 2022; 22:803-812. [PMID: 36242715 DOI: 10.1007/s11910-022-01238-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2022] [Indexed: 01/27/2023]
Abstract
PURPOSE OF REVIEW To provide perspectives on the importance of understanding longitudinal profiles of posterior cortical atrophy (PCA) and report results of a scoping review to identify data and knowledge gaps related to PCA survival and longitudinal clinical and biomarker outcomes. RECENT FINDINGS Thirteen longitudinal studies were identified; all but two had fewer than 30 participants with PCA. Relatively few longitudinal data exist, particularly for survival. In PCA, posterior cortical dysfunction and atrophy progress at faster rates compared to non-posterior regions, potentially up to a decade after symptom onset. Unlike typical AD, PCA phenotype-defined cognitive dysfunction and atrophy remain relatively more severe compared to other regions throughout the PCA course. Select cognitive tests hold promise as PCA outcome measures and for staging. Further longitudinal investigations are critically needed to enable PCA inclusion in treatment trials and to provide appropriate care to patients and enhance our understanding of the pathophysiology of dementing diseases.
Collapse
Affiliation(s)
- Victoria S Pelak
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, USA. .,Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA.
| | - Asher Mahmood
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Kathryn Abe-Ridgway
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, USA
| |
Collapse
|
5
|
Marzouki Y, Al-Otaibi SA, Al-Tamimi MT, Idrissi A. Can the word superiority effect be modulated by serial position and prosodic structure? Front Psychol 2022; 13:915666. [PMID: 35992439 PMCID: PMC9389116 DOI: 10.3389/fpsyg.2022.915666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 07/05/2022] [Indexed: 11/13/2022] Open
Abstract
In this study, we examined the word superiority effect in Arabic and English, two languages with significantly different morphological and writing systems. Thirty-two Arabic–English bilingual speakers performed a post-cued letter-in-string identification task in words, pseudo-words, and non-words. The results established the presence of the word superiority effect in Arabic and a robust effect of context in both languages. However, they revealed that, compared to the non-word context, word and pseudo-word contexts facilitated letter identification more in Arabic than in English. In addition, the difference between word and pseudo-word contexts was smaller in Arabic compared to English. Finally, there was a consistent first-letter advantage in English regardless of the context, while this was more consistent only in the word and pseudo-word contexts in Arabic. We discuss these results in light of previous findings and argue that the differences between the patterns reported for Arabic and English are due to the qualitative difference between word morphophonological representations in the two languages.
Collapse
Affiliation(s)
- Yousri Marzouki
- Department of Social Sciences, College of Arts and Sciences, Qatar University, Doha, Qatar
- *Correspondence: Yousri Marzouki
| | | | | | - Ali Idrissi
- Department of English Literature and Linguistics, College of Arts and Sciences, Qatar University, Doha, Qatar
| |
Collapse
|
6
|
Abstract
Alexia refers to a reading disorder caused by some form of acquired brain pathology, most commonly a stroke or tumor, in a previously literate subject. In neuropsychology, a distinction is made between central alexia (commonly seen in aphasia) and peripheral alexia (a perceptual or attentional deficit). The prototypical peripheral alexia is alexia without agraphia (pure alexia), where patients can write but are impaired in reading words and letters. Pure alexia is associated with damage to the left ventral occipitotemporal cortex (vOT) or its connections. Hemianopic alexia is associated with less extensive occipital damage and is caused by a visual field defect, which creates problems reading longer words and passages of text. Reading impairment can also arise due to attentional deficits, most commonly following right hemisphere or bilateral lesions. Studying patients with alexia, along with functional imaging studies of normal readers, has improved our understanding of the neurobiological processes involved in reading. A key question is whether an area in the left ventral occipitotemporal cortex is specialized for or selectively involved in word processing, or whether reading relies on tuning of more general purpose perceptual areas. Reading deficits may also be observed in dementia and traumatic brain injury, but often with less consistent deficit patterns than in patients with focal lesions.
Collapse
Affiliation(s)
- Randi Starrfelt
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
| | - Zoe Woodhead
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
| |
Collapse
|
7
|
Glick-Shames H, Keadan T, Backner Y, Bick A, Levin N. Global Brain Involvement in Posterior Cortical Atrophy: Multimodal MR Imaging Investigation. Brain Topogr 2020; 33:600-612. [PMID: 32761400 DOI: 10.1007/s10548-020-00788-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 07/23/2020] [Indexed: 02/04/2023]
Abstract
Posterior cortical atrophy (PCA), considered a visual variant of Alzheimer's disease, has similar pathological characteristics yet shows a selective visual manifestation with relative preservation of other cortical areas, at least at early stages of disease. Using a gamut of imaging methods, we aim to evaluate the global aspect of this relatively local disease and describe the interplay of the involvement of the different brain components. Ten PCA patients and 14 age-matched controls underwent MRI scans. Cortical thickness was examined to identify areas of cortical thinning. Hippocampal volume was assessed using voxel-based morphometry. The integrity of 20 fiber tracts was assessed by Diffusion Tensor Imaging. Regions of difference in global functional connectivity were identified by resting-state fMRI, using multi-variant pattern analysis. Correlations were examined to evaluate the connection between grey matter atrophy, the network changes and the disease load. The patients presented bilateral cortical thinning, primarily in their brains' posterior segments. Impaired segments of white matter integrity were evident only within three fiber tracts in the left hemisphere. Four areas were identified as different in their global connectivity pattern. The visual network-related areas showed reduced connectivity and was correlated to atrophy. Right Broadman area 39 showed in addition increased connectivity to the frontal areas. Global structural and functional imaging pointed to the highly localized nature of PCA. Functional connectivity followed grey matter atrophy in visual regions. White matter involvement seemed less prominent, however damage is directly related to presence of disease and not mediated only by grey matter damage.
Collapse
Affiliation(s)
- Haya Glick-Shames
- fMRI Lab, Neurology Department, Hadassah-Hebrew University Medical Center, POB 12000, Jerusalem, 91120, Israel
| | - Tarek Keadan
- fMRI Lab, Neurology Department, Hadassah-Hebrew University Medical Center, POB 12000, Jerusalem, 91120, Israel
| | - Yael Backner
- fMRI Lab, Neurology Department, Hadassah-Hebrew University Medical Center, POB 12000, Jerusalem, 91120, Israel
| | - Atira Bick
- fMRI Lab, Neurology Department, Hadassah-Hebrew University Medical Center, POB 12000, Jerusalem, 91120, Israel
| | - Netta Levin
- fMRI Lab, Neurology Department, Hadassah-Hebrew University Medical Center, POB 12000, Jerusalem, 91120, Israel.
| |
Collapse
|
8
|
Firth NC, Primativo S, Marinescu RV, Shakespeare TJ, Suarez-Gonzalez A, Lehmann M, Carton A, Ocal D, Pavisic I, Paterson RW, Slattery CF, Foulkes AJM, Ridha BH, Gil-Néciga E, Oxtoby NP, Young AL, Modat M, Cardoso MJ, Ourselin S, Ryan NS, Miller BL, Rabinovici GD, Warrington EK, Rossor MN, Fox NC, Warren JD, Alexander DC, Schott JM, Yong KXX, Crutch SJ. Longitudinal neuroanatomical and cognitive progression of posterior cortical atrophy. Brain 2019; 142:2082-2095. [PMID: 31219516 PMCID: PMC6598737 DOI: 10.1093/brain/awz136] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 02/28/2019] [Accepted: 03/24/2019] [Indexed: 01/27/2023] Open
Abstract
Posterior cortical atrophy is a clinico-radiological syndrome characterized by progressive decline in visual processing and atrophy of posterior brain regions. With the majority of cases attributable to Alzheimer's disease and recent evidence for genetic risk factors specifically related to posterior cortical atrophy, the syndrome can provide important insights into selective vulnerability and phenotypic diversity. The present study describes the first major longitudinal investigation of posterior cortical atrophy disease progression. Three hundred and sixty-one individuals (117 posterior cortical atrophy, 106 typical Alzheimer's disease, 138 controls) fulfilling consensus criteria for posterior cortical atrophy-pure and typical Alzheimer's disease were recruited from three centres in the UK, Spain and USA. Participants underwent up to six annual assessments involving MRI scans and neuropsychological testing. We constructed longitudinal trajectories of regional brain volumes within posterior cortical atrophy and typical Alzheimer's disease using differential equation models. We compared and contrasted the order in which regional brain volumes become abnormal within posterior cortical atrophy and typical Alzheimer's disease using event-based models. We also examined trajectories of cognitive decline and the order in which different cognitive tests show abnormality using the same models. Temporally aligned trajectories for eight regions of interest revealed distinct (P < 0.002) patterns of progression in posterior cortical atrophy and typical Alzheimer's disease. Patients with posterior cortical atrophy showed early occipital and parietal atrophy, with subsequent higher rates of temporal atrophy and ventricular expansion leading to tissue loss of comparable extent later. Hippocampal, entorhinal and frontal regions underwent a lower rate of change and never approached the extent of posterior cortical involvement. Patients with typical Alzheimer's disease showed early hippocampal atrophy, with subsequent higher rates of temporal atrophy and ventricular expansion. Cognitive models showed tests sensitive to visuospatial dysfunction declined earlier in posterior cortical atrophy than typical Alzheimer's disease whilst tests sensitive to working memory impairment declined earlier in typical Alzheimer's disease than posterior cortical atrophy. These findings indicate that posterior cortical atrophy and typical Alzheimer's disease have distinct sites of onset and different profiles of spatial and temporal progression. The ordering of disease events both motivates investigation of biological factors underpinning phenotypic heterogeneity, and informs the selection of measures for clinical trials in posterior cortical atrophy.
Collapse
Affiliation(s)
- Nicholas C Firth
- Dementia Research Centre, Institute of Neurology, University College London, 8–11 Queen Square, London, UK
- Centre for Medical Image Computing, Department of Computer Science, University College London, Gower Street, London, UK
| | - Silvia Primativo
- Dementia Research Centre, Institute of Neurology, University College London, 8–11 Queen Square, London, UK
- Department of Human Science, LUMSA University, Via della Traspontina, 21, Rome, Italy
| | - Razvan-Valentin Marinescu
- Centre for Medical Image Computing, Department of Computer Science, University College London, Gower Street, London, UK
| | - Timothy J Shakespeare
- Dementia Research Centre, Institute of Neurology, University College London, 8–11 Queen Square, London, UK
| | - Aida Suarez-Gonzalez
- Dementia Research Centre, Institute of Neurology, University College London, 8–11 Queen Square, London, UK
- Department of Neurology, University Hospital Virgen del Rocio, Seville, Spain
| | - Manja Lehmann
- Dementia Research Centre, Institute of Neurology, University College London, 8–11 Queen Square, London, UK
- Memory and Aging Center, University of California San Francisco, San Francisco, California, USA
| | - Amelia Carton
- Dementia Research Centre, Institute of Neurology, University College London, 8–11 Queen Square, London, UK
| | - Dilek Ocal
- Dementia Research Centre, Institute of Neurology, University College London, 8–11 Queen Square, London, UK
| | - Ivanna Pavisic
- Dementia Research Centre, Institute of Neurology, University College London, 8–11 Queen Square, London, UK
| | - Ross W Paterson
- Dementia Research Centre, Institute of Neurology, University College London, 8–11 Queen Square, London, UK
| | - Catherine F Slattery
- Dementia Research Centre, Institute of Neurology, University College London, 8–11 Queen Square, London, UK
| | - Alexander J M Foulkes
- Dementia Research Centre, Institute of Neurology, University College London, 8–11 Queen Square, London, UK
| | - Basil H Ridha
- Dementia Research Centre, Institute of Neurology, University College London, 8–11 Queen Square, London, UK
| | - Eulogio Gil-Néciga
- Department of Neurology, University Hospital Virgen del Rocio, Seville, Spain
| | - Neil P Oxtoby
- Centre for Medical Image Computing, Department of Computer Science, University College London, Gower Street, London, UK
| | - Alexandra L Young
- Centre for Medical Image Computing, Department of Computer Science, University College London, Gower Street, London, UK
| | - Marc Modat
- School of Biomedical Engineering and Imaging Sciences, King's College London, UK
| | - M Jorge Cardoso
- School of Biomedical Engineering and Imaging Sciences, King's College London, UK
| | - Sebastien Ourselin
- School of Biomedical Engineering and Imaging Sciences, King's College London, UK
| | - Natalie S Ryan
- Dementia Research Centre, Institute of Neurology, University College London, 8–11 Queen Square, London, UK
| | - Bruce L Miller
- Memory and Aging Center, University of California San Francisco, San Francisco, California, USA
| | - Gil D Rabinovici
- Memory and Aging Center, University of California San Francisco, San Francisco, California, USA
| | - Elizabeth K Warrington
- Dementia Research Centre, Institute of Neurology, University College London, 8–11 Queen Square, London, UK
| | - Martin N Rossor
- Dementia Research Centre, Institute of Neurology, University College London, 8–11 Queen Square, London, UK
| | - Nick C Fox
- Dementia Research Centre, Institute of Neurology, University College London, 8–11 Queen Square, London, UK
| | - Jason D Warren
- Dementia Research Centre, Institute of Neurology, University College London, 8–11 Queen Square, London, UK
| | - Daniel C Alexander
- Centre for Medical Image Computing, Department of Computer Science, University College London, Gower Street, London, UK
| | - Jonathan M Schott
- Dementia Research Centre, Institute of Neurology, University College London, 8–11 Queen Square, London, UK
| | - Keir X X Yong
- Dementia Research Centre, Institute of Neurology, University College London, 8–11 Queen Square, London, UK
| | - Sebastian J Crutch
- Dementia Research Centre, Institute of Neurology, University College London, 8–11 Queen Square, London, UK
| |
Collapse
|
9
|
Chen Y, Liu P, Wang Y, Peng G. Neural Mechanisms of Visual Dysfunction in Posterior Cortical Atrophy. Front Neurol 2019; 10:670. [PMID: 31293507 PMCID: PMC6603128 DOI: 10.3389/fneur.2019.00670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 06/07/2019] [Indexed: 11/13/2022] Open
Abstract
Posterior cortical atrophy (PCA) is characterized predominantly by visual dysfunction that arises from bilateral impairments in occipital, parietal, and temporal regions of the brain. PCA is clinically identified based primarily on visual symptoms and neuroimaging findings. Region-specific gray and white matter deficits have been discussed in detail, and are associated with clinical manifestations that present with similar patterns of perfusion and metabolic findings. Here, we discuss both structural and functional changes in the ventral and dorsal visual streams along with their underlying relationships. We also discuss the most recent developments in neuroimaging characteristics and summarize correlations between distinct neuroimaging presentations.
Collapse
Affiliation(s)
- Yi Chen
- Department of Neurology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ping Liu
- Department of Neurology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yunyun Wang
- Department of Neurology, Shengzhou People's Hospital, Shengzhou, China
| | - Guoping Peng
- Department of Neurology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- *Correspondence: Guoping Peng
| |
Collapse
|
10
|
Sand K, Robotham RJ, Martelli M, Starrfelt R. Visual crowding in pure alexia and acquired prosopagnosia. Cogn Neuropsychol 2018; 35:361-370. [DOI: 10.1080/02643294.2018.1483325] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Katrine Sand
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Ro Julia Robotham
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | | | - Randi Starrfelt
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
11
|
Sand K, Habekost T, Petersen A, Starrfelt R. The Word Superiority Effect in central and peripheral vision. VISUAL COGNITION 2016. [DOI: 10.1080/13506285.2016.1259192] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
12
|
Abstract
Posterior cortical atrophy (PCA) is the canonical “visual dementia,” with affected individuals experiencing a progressive disintegration of their visual world owing to dysfunction and atrophy at the back of the brain. The syndrome, which also affects literacy, numeracy, and gesture, is typically caused by Alzheimer’s disease, but is distinguished from more common amnestic presentations by virtue of relatively preserved episodic memory and insight. Although problems with object and space perception are the most widely reported and investigated symptoms, these higher-order perceptual difficulties are often underpinned by an array of changes in more basic visual and oculomotor processes. Here we review recent studies providing insights into these more elementary aspects of vision in PCA, including fixation stability, saccade generation, point localization, excessive crowding, and factors affecting the effective field of vision. We argue that a more detailed appreciation of these fundamental changes in the early visual system not only will improve the characterization and understanding of this rare clinico-radiological syndrome but will also guide the design of visual aids and strategies aimed at maintaining everyday abilities in individuals with PCA.
Collapse
Affiliation(s)
- Sebastian J. Crutch
- Dementia Research Centre, Department of Neurodegeneration, Institute of Neurology, University College London
| | - Keir X. X. Yong
- Dementia Research Centre, Department of Neurodegeneration, Institute of Neurology, University College London
| | - Timothy J. Shakespeare
- Dementia Research Centre, Department of Neurodegeneration, Institute of Neurology, University College London
| |
Collapse
|