A Case of Overlap Posterior Cortical Atrophy and Logopenic Variant Primary Progressive Aphasia

The Neurologist
Donal FitzpatrickLorraine Kyne

Abstract

Posterior cortical atrophy (PCA) and logopenic variant primary progressive aphasia (LvPPA) are considered early-onset dementias most commonly caused by Alzheimer pathology. PCA is characterized by a progressive decline in higher order visual processing functions, whereas LvPPA is a form of primary progressive aphasia. The clinical presentation of both syndromes is typically earlier in life relative to the more typical "amnestic" form of Alzheimer disease. Prominent language deficits have been well described in PCA. Here, we describe the case of a 56-year-old man presenting with overlapping anatomic, clinical, and cognitive features of PCA and LvPPA and review the existing literature relating to the clinical features shared by these conditions, exploring the etiology, and implications for clinical practice in cases with a PCA-LvPPA overlap syndrome. In PCA, atrophy occurs in temporoparietal-occipital regions, whereas in LvPPA atrophy occurs at the temporoparietal junctions, with left-sided predominance. A defective phonological loop (a short-term storage system which holds speech sounds in memory for 1 to 2 s) seems to underlie the logopenic syndrome in both conditions. Other parietal lobe deficits, in proximity to both language...Continue Reading

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