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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.
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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.
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Wong B, Lucente DE, MacLean J, Padmanabhan J, Quimby M, Brandt KD, Putcha D, Sherman J, Frosch MP, McGinnis S, Dickerson BC. Diagnostic evaluation and monitoring of patients with posterior cortical atrophy. Neurodegener Dis Manag 2019; 9:217-239. [PMID: 31392920 PMCID: PMC6949516 DOI: 10.2217/nmt-2018-0052] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Accepted: 05/03/2019] [Indexed: 12/21/2022] Open
Abstract
Posterior cortical atrophy (PCA) is a progressive neurocognitive syndrome, most commonly associated with the loss of complex visuospatial functions. Diagnosis is challenging, and international consensus classification and nomenclature for PCA subtypes have only recently been reached. Presently, no established treatments exist. Efforts to develop treatments are hampered by the lack of standardized methods to monitor illness progression. Although measures developed from work with Alzheimer's disease and other dementias provide a foundation for diagnosing and monitoring progression, PCA presents unique challenges for clinicians counseling patients and families on clinical status and prognosis, and experts designing clinical trials of interventions. Here, we review issues facing PCA clinical research and care, summarize our approach to diagnosis and monitoring of disease progression, and outline ideas for developing tools for these purposes.
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Affiliation(s)
- Bonnie Wong
- Posterior Cortical Atrophy Program, Frontotemporal Disorders Unit, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Diane E Lucente
- Posterior Cortical Atrophy Program, Frontotemporal Disorders Unit, Massachusetts General Hospital, Boston, MA 02114, USA
- Centerfor Genomic Medicine, Massachusetts General Hospital & Harvard Medical School, Boston, MA 02114, USA
| | - Julie MacLean
- Department of Physical & Occupational Therapy, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Jaya Padmanabhan
- Posterior Cortical Atrophy Program, Frontotemporal Disorders Unit, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Neurology, Division of Cognitive Neurology, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA
| | - Megan Quimby
- Posterior Cortical Atrophy Program, Frontotemporal Disorders Unit, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Neurology, Massachusetts General Hospital, Boston,MA 02114, USA
- Department of Speech & Language Pathology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Katherine D Brandt
- Posterior Cortical Atrophy Program, Frontotemporal Disorders Unit, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Neurology, Massachusetts General Hospital, Boston,MA 02114, USA
| | - Deepti Putcha
- Posterior Cortical Atrophy Program, Frontotemporal Disorders Unit, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Janet Sherman
- Posterior Cortical Atrophy Program, Frontotemporal Disorders Unit, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Matthew P Frosch
- Department of Pathology, Division of Neuropathology, Massachusetts General Hospital, Boston, MA 02114, USA
- Massachusetts Alzheimer’s Disease Research Center, Boston, MA 02129, USA
| | - Scott McGinnis
- Posterior Cortical Atrophy Program, Frontotemporal Disorders Unit, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Neurology, Massachusetts General Hospital, Boston,MA 02114, USA
- Department of Neurology, Division of Cognitive & Behavioral Neurology, Brigham & Women's Hospital, Boston, MA 02115, USA
| | - Bradford C Dickerson
- Posterior Cortical Atrophy Program, Frontotemporal Disorders Unit, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Neurology, Massachusetts General Hospital, Boston,MA 02114, USA
- Massachusetts Alzheimer’s Disease Research Center, Boston, MA 02129, USA
- Athinoula A Martinos Center for Biomedical Imaging, Charlestown, MA 02129, USA
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3
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Bier N, El-Samra A, Bottari C, Vallet G, Carignan M, Paquette G, Brambati S, Demers L, Génier-Marchand D, Rouleau I. Posterior cortical atrophy: Impact on daily living activities and exploration of a cognitive rehabilitation approach. COGENT PSYCHOLOGY 2019. [DOI: 10.1080/23311908.2019.1634911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- N. Bier
- School of rehabilitation, Université de Montréal, Montréal, Canada
- Centre de recherche, Institut universitaire de gériatrie de Montréal, CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montreal, Canada
| | - A. El-Samra
- School of rehabilitation, Université de Montréal, Montréal, Canada
| | - C. Bottari
- School of rehabilitation, Université de Montréal, Montréal, Canada
- Centre de recherche en réadaptation du Montréal Métropolitain (CRIR), Montreal, Canada
| | - G.T. Vallet
- Centre de recherche, Institut universitaire de gériatrie de Montréal, CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montreal, Canada
| | - M. Carignan
- Centre de recherche en réadaptation du Montréal Métropolitain (CRIR), Montreal, Canada
- Institut Nazareth et Louis Braille, CISSS de la Montérégie-Centre, Montreal, Canada
| | - G. Paquette
- Centre de recherche, Institut universitaire de gériatrie de Montréal, CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montreal, Canada
- Centre de recherche en réadaptation du Montréal Métropolitain (CRIR), Montreal, Canada
| | - S. Brambati
- Centre de recherche, Institut universitaire de gériatrie de Montréal, CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montreal, Canada
- Department of psychology, Université de Montréal, Montreal, Canada
| | - L. Demers
- School of rehabilitation, Université de Montréal, Montréal, Canada
- Centre de recherche, Institut universitaire de gériatrie de Montréal, CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montreal, Canada
| | - D. Génier-Marchand
- Department of psychology, Université du Québec à Montréal, Montreal, Canada
| | - I. Rouleau
- Department of psychology, Université du Québec à Montréal, Montreal, Canada
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Esteves S, Ramirez Romero DA, Torralva T, Martínez Cuitiño M, Herndon S, Couto B, Ibañez A, Manes F, Roca M. Posterior cortical atrophy: a single case cognitive and radiological follow-up. Neurocase 2018; 24:16-30. [PMID: 29308699 DOI: 10.1080/13554794.2017.1421667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Posterior cortical atrophy (PCA) is a rare neurodegenerative syndrome characterized by initial predominant visuoperceptual deficits followed by a progressive decline in other cognitive functions. This syndrome has not been as thoroughly described as other dementias, particularly from a neuropsychological evolution perspective with only a few studies describing the evolution of its cognitive progression. In this investigation we review the literature on this rare condition and we perform a 7-year neuropsychological and neuroradiological follow-up of a 64-year-old man with PCA. The subject's deficits initially appeared in his visuoperceptual skills with later affectation appearing in language and other cognitive functions, this being coherent with the patient's parieto-temporal atrophy evolution.
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Affiliation(s)
- Sol Esteves
- a Neuropsychological Research Laboratory, Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, CONICET , Buenos Aires , Argentina
| | - Diana Andrea Ramirez Romero
- a Neuropsychological Research Laboratory, Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, CONICET , Buenos Aires , Argentina
| | - Teresa Torralva
- a Neuropsychological Research Laboratory, Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, CONICET , Buenos Aires , Argentina
| | - Macarena Martínez Cuitiño
- a Neuropsychological Research Laboratory, Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, CONICET , Buenos Aires , Argentina
| | - Shannon Herndon
- a Neuropsychological Research Laboratory, Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, CONICET , Buenos Aires , Argentina.,b Department of Psychiatry, School of Medicine, University of North Carolina Chapel Hill , Chapel Hill , USA
| | - Blas Couto
- c Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, CONICET , Buenos Aires , Argentina
| | - Agustín Ibañez
- c Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, CONICET , Buenos Aires , Argentina.,d Centre of Excellence in Cognition and its Disorders, Australian Research Council (ACR) , Sydney , Australia.,e Universidad Autónoma del Caribe, Barranquilla , Colombia.,f Centre for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibañez , Santiago de Chile , Chile.,g National Scientific and Technical Research Council (CONICET) , Buenos Aires , Argentina
| | - Facundo Manes
- d Centre of Excellence in Cognition and its Disorders, Australian Research Council (ACR) , Sydney , Australia.,g National Scientific and Technical Research Council (CONICET) , Buenos Aires , Argentina
| | - María Roca
- g National Scientific and Technical Research Council (CONICET) , Buenos Aires , Argentina
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5
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The Nature and Natural History of Posterior Cortical Atrophy Syndrome. Alzheimer Dis Assoc Disord 2017; 31:295-306. [DOI: 10.1097/wad.0000000000000207] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Weill-Chounlamountry A, Alves J, Pradat-Diehl P. Non-pharmacological intervention for posterior cortical atrophy. World J Clin Cases 2016; 4:195-201. [PMID: 27574605 PMCID: PMC4983688 DOI: 10.12998/wjcc.v4.i8.195] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 04/26/2016] [Accepted: 05/27/2016] [Indexed: 02/05/2023] Open
Abstract
Posterior cortical atrophy (PCA) is a rare neurodegenerative condition characterized by progressive visual-perceptual deficits. Although the neurocognitive profile of PCA is a growing and relatively well-established field, non-pharmacological care remains understudied and to be widely established in clinical practice. In the present work we review the available literature on non-pharmacological approaches for PCA, such as cognitive rehabilitation including individual cognitive exercises and compensatory techniques to improve autonomy in daily life, and psycho-education aiming to inform people with PCA about the nature of their visual deficits and limits of cognitive rehabilitation. The reviewed studies represented a total of 7 patients. There is a scarcity of the number of studies, and mostly consisting of case studies. Results suggest non-pharmacological intervention to be a potentially beneficial approach for the partial compensation of deficits, improvement of daily functionality and improvement of quality of life. Clinical implications and future directions are also highlighted for the advancement of the field, in order to clarify the possible role of non-pharmacological interventions, and its extent, in PCA.
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Abstract
Receptor for advanced glycation end products (RAGE) is a receptor of the immunoglobulin super family that plays various important roles under physiological and pathological conditions. Compelling evidence suggests that RAGE acts as both an inflammatory intermediary and a critical inducer of oxidative stress, underlying RAGE-induced Alzheimer-like pathophysiological changes that drive the process of Alzheimer's disease (AD). A critical role of RAGE in AD includes beta-amyloid (Aβ) production and accumulation, the formation of neurofibrillary tangles, failure of synaptic transmission, and neuronal degeneration. The steady-state level of Aβ depends on the balance between production and clearance. RAGE plays an important role in the Aβ clearance. RAGE acts as an important transporter via regulating influx of circulating Aβ into brain, whereas the efflux of brain-derived Aβ into the circulation via BBB is implemented by LRP1. RAGE could be an important contributor to Aβ generation via enhancing the activity of β- and/or γ-secretases and activating inflammatory response and oxidative stress. However, sRAGE-Aβ interactions could inhibit Aβ neurotoxicity and promote Aβ clearance from brain. Meanwhile, RAGE could be a promoting factor for the synaptic dysfunction and neuronal circuit dysfunction which are both the material structure of cognition, and the physiological and pathological basis of cognition. In addition, RAGE could be a trigger for the pathogenesis of Aβ and tau hyper-phosphorylation which both participate in the process of cognitive impairment. Preclinical and clinical studies have supported that RAGE inhibitors could be useful in the treatment of AD. Thus, an effective measure to inhibit RAGE may be a novel drug target in AD.
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