Posterior Cortical Atrophy

Posterior cortical atrophy (PCA) is a progressive degeneration of the outer layer of the brain (cortex) in the posterior region (back of the head).

About

The exact nature of posterior cortical atrophy is still unclear. Some individuals with PCA exhibit similar brain changes to Alzheimer’s disease, such as amyloid plaques and neurofibrillary tangles, but in a different brain region. In other cases, the brain changes resemble other disorders like dementia with Lewy bodies or Creutzfeldt-Jakob disease. While most cases of Alzheimer’s disease occur in individuals aged 65 and older, PCA typically emerges between ages 50 and 65.

Causes and Risk Factors

The exact causes of PCA are unknown, and there are no known genetic mutations linked to the condition. It is also uncertain if the risk factors for Alzheimer’s disease are applicable to PCA.

Symptoms

PCA symptoms vary among individuals and can change as the condition progresses. Common symptoms relate to visual processing difficulties caused by damage to the posterior cortex of the brain. These include challenges with reading, judging distances, distinguishing moving and stationary objects, perceiving multiple objects simultaneously, disorientation, and difficulties using tools or common objects. Hallucinations may occur, and other symptoms can involve difficulties with mathematical calculations, spelling, and increased anxiety. Memory impairment typically becomes more evident in later stages, but early stages may not exhibit significant memory decline.

Diagnosis

Diagnosing Korsakoff syndrome relies on clinical judgment based on a person’s symptoms. There are no specific laboratory tests or neuroimaging procedures to confirm the disorder. Diagnosis can be challenging as the symptoms may be masked by other common conditions among alcohol misusers, such as intoxication, withdrawal, infection, or head injury. Medical evaluations for memory loss or cognitive changes should always include questions about alcohol use. People admitted to the hospital for alcohol-related conditions should undergo professional screening for memory loss and cognitive changes, including detailed cognitive assessments if impairment is suspected.

Outcomes and Treatment

There are no known treatments to slow or halt the progression of PCA. Some medications used for temporary relief in Alzheimer’s disease may be suggested for managing brain dysfunction in PCA, but their effectiveness is unproven. Symptom alleviation treatments such as addressing depression or anxiety may benefit some individuals, but the overall benefits and risks are not established.