Charles Raquel F, Hillis Argye E
Department of Medicine, Johns Hopkins University School of Medicine, 1830 E. Monument Street, Ninth Floor, Baltimore, MD 21287, USA.
Behav Neurol. 2005;16(1):15-23. doi: 10.1155/2005/762569.
Posterior cortical atrophy (PCA) is an uncommon dementia syndrome with initial manifestations of visual dysfunction and preservation of memory and language until late in the disease. Since prognosis and management differ from typical Alzheimer's disease (tAD), clinical tests to distinguish PCA from tAD are needed.
Fifteen PCA cases and 15 tAD cases, defined by clinical and MRI criteria, were compared by present symptoms and scores on four cognitive tests.
Symptoms of visual disturbance and dyslexia were more commonly reported in PCA cases (p = 0.0001 and p = 0.006, respectively), and memory loss was more commonly reported in tAD (p = 0.006). Patients with PCA were less accurate on the Cortical Vision Screening Test (t = 6.0; p < 0.001) and in copying the Rey-Osterreith Complex Figure (t = 6.0; p < 0.001), in comparison to the tAD group. Memory, evaluated by the Rey Auditory Verbal Learning Test, was impaired in both groups; however, delayed recall was more impaired in the tAD group (t = 2.5; p = 0.03).
Compared to patients with tAD, patients with PCA are more likely to present to their providers with symptoms of visual dysfunction. Performance on simple tests of visual perception and copying can be used to distinguish the two disorders even a few years after initial symptoms.
后皮质萎缩（PCA）是一种罕见的痴呆综合征，其初始表现为视觉功能障碍，在疾病晚期之前记忆和语言功能得以保留。由于其预后和治疗方法与典型阿尔茨海默病（tAD）不同，因此需要有临床测试来区分PCA和tAD。
根据临床和MRI标准定义了15例PCA病例和15例tAD病例，通过当前症状和四项认知测试的得分对两者进行比较。
PCA病例中更常报告视觉障碍和诵读困难症状（分别为p = 0.0001和p = 0.006），而tAD中更常报告记忆丧失（p = 0.006）。与tAD组相比，PCA患者在皮质视觉筛查测试（t = 6.0；p < 0.001）和复制雷-奥斯特里思复杂图形（t = 6.0；p < 0.001）时准确性较低。通过雷氏听觉词语学习测试评估的记忆在两组中均受损；然而，延迟回忆在tAD组中受损更严重（t = 2.5；p = 0.03）。
与tAD患者相比，PCA患者更有可能因视觉功能障碍症状就医。即使在出现初始症状几年后，简单的视觉感知和复制测试表现也可用于区分这两种疾病。
