TY - JOUR
T1 - Aphasia with left occipitotemporal hypometabolism
T2 - A novel presentation of posterior cortical atrophy?
AU - Wicklund, Meredith R.
AU - Duffy, Joseph R.
AU - Strand, Edythe A.
AU - Whitwell, Jennifer L.
AU - MacHulda, Mary M.
AU - Josephs, Keith A.
N1 - Funding Information:
This study was supported by NIH R01-AG037491.
Funding Information:
Dr. Josephs is funded by NIH R01-DC010367 (PI), R01-AG037491 (PI), R21-AG38736 (Co-I), and the Dana Foundation (PI).
Funding Information:
Dr. Whitwell is funded by NIH R21-AG38736 (PI), R01-DC010367 (Co-I), R01-AG037491 (Co-I), and the Dana Foundation (Co-I).
PY - 2013/9
Y1 - 2013/9
N2 - Alzheimer's disease is a common neurodegenerative disease often characterized by initial episodic memory loss. Atypical focal cortical presentations have been described, including the logopenic variant of primary progressive aphasia (lvPPA) which presents with language impairment, and posterior cortical atrophy (PCA) which presents with prominent visuospatial deficits. Both lvPPA and PCA are characterized by specific patterns of hypometabolism: left temporoparietal in lvPPA and bilateral parietoccipital in PCA. However, not every patient fits neatly into these categories. We retrospectively identified two patients with progressive aphasia and visuospatial deficits from a speech and language based disorders study. The patients were further characterized by MRI, fluorodeoxyglucose F18 and Pittsburgh Compound B (PiB) positron emission tomography. Two women, aged 62 and 69, presented with a history of a few years of progressive aphasia characterized by fluent output with normal grammar and syntax, anomia without loss of word meaning, and relatively spared repetition. They demonstrated striking deficits in visuospatial function for which they were lacking insight. Prominent hypometabolism was noted in the left occipitotemporal region and diffuse retention of PiB was noted. Posterior cortical atrophy may present focally with left occipitotemporal metabolism characterized clinically with a progressive fluent aphasia and prominent ventral visuospatial deficits with loss of insight.
AB - Alzheimer's disease is a common neurodegenerative disease often characterized by initial episodic memory loss. Atypical focal cortical presentations have been described, including the logopenic variant of primary progressive aphasia (lvPPA) which presents with language impairment, and posterior cortical atrophy (PCA) which presents with prominent visuospatial deficits. Both lvPPA and PCA are characterized by specific patterns of hypometabolism: left temporoparietal in lvPPA and bilateral parietoccipital in PCA. However, not every patient fits neatly into these categories. We retrospectively identified two patients with progressive aphasia and visuospatial deficits from a speech and language based disorders study. The patients were further characterized by MRI, fluorodeoxyglucose F18 and Pittsburgh Compound B (PiB) positron emission tomography. Two women, aged 62 and 69, presented with a history of a few years of progressive aphasia characterized by fluent output with normal grammar and syntax, anomia without loss of word meaning, and relatively spared repetition. They demonstrated striking deficits in visuospatial function for which they were lacking insight. Prominent hypometabolism was noted in the left occipitotemporal region and diffuse retention of PiB was noted. Posterior cortical atrophy may present focally with left occipitotemporal metabolism characterized clinically with a progressive fluent aphasia and prominent ventral visuospatial deficits with loss of insight.
KW - Alzheimer dementia
KW - Aphasia
KW - Functional neuroimaging
KW - Neuropsychology
KW - Visual agnosia
UR - http://www.scopus.com/inward/record.url?scp=84883135743&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84883135743&partnerID=8YFLogxK
U2 - 10.1016/j.jocn.2013.01.002
DO - 10.1016/j.jocn.2013.01.002
M3 - Article
C2 - 23850398
AN - SCOPUS:84883135743
SN - 0967-5868
VL - 20
SP - 1237
EP - 1240
JO - Journal of Clinical Neuroscience
JF - Journal of Clinical Neuroscience
IS - 9
ER -