Consensus recommendations for clinical assessment tools for the diagnosis of posterior cortical atrophy syndrome from the Atypical AD PIA of ISTAART

Author:

Pelak Victoria S.1ORCID,Tang‐Wai David F.2,Boeve Bradley F.3,Bouwman Femke H.4,Graff‐Radford Jonathan3,Rabinovici Gil5,Holden Samantha K.6,Townley Ryan A.7,Day Gregory S.8,Whitwell Jennifer9,Ossenkoppele Rik410,Boon Baayla D. C.11,Putcha Deepti12,Onyike Chiadi U.13,Snyder Heather14,Crutch Sebastian15,Yong Keir X. X.15ORCID

Affiliation:

1. Departments of Neurology and Ophthalmology University of Colorado School of Medicine, Aurora Victoria Colorado USA

2. Department of Medicine (Neurology) University of Toronto Toronto Canada

3. Department of Neurology Mayo Clinic Rochester Minnesota USA

4. Department of Neurology Vrije Universiteit Amsterdam Amsterdam The Netherlands

5. Department of Neurology University of California San Francisco San Francisco California USA

6. Department of Neurology University of Colorado School of Medicine Aurora Colorado USA

7. Department of Neurology University of Kansas School of Medicine Kansas City Kansas USA

8. Department of Neurology Mayo Clinic Jacksonville Jacksonville Florida USA

9. Department of Radiology Division of Neuroradiology Mayo Clinic Rochester Minnesota USA

10. Clinical Memory Research Unit Lund University Lund Sweden

11. Department of Neuroscience Mayo Clinic Jacksonville Jacksonville Florida USA

12. Department of Psychiatry Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA

13. Department of Psychiatry Johns Hopkins Medicine Baltimore Maryland USA

14. Medical & Scientific Relations Alzheimer's Association Chicago Illinois USA

15. UCL Queen Square Institute of Neurology Dementia Research Centre London UK

Abstract

AbstractINTRODUCTIONDelay in diagnosis of posterior cortical atrophy (PCA) syndrome is common, and the lack of familiarity with assessment tools for identifying visual cortical dysfunction is a contributing factor. We propose recommendations for the approach to the evaluation of PCA clinical features during the office visit, the neuropsychological evaluation, and the research setting. A recommended screening battery for eye clinics is also proposed.METHODSRecommendations were developed using results from a web‐based survey of members of Alzheimer's Association International Society to Advance Alzheimer's Research and Treatment (ISTAART) Atypical Alzheimer's Disease Professional Interest Area (PIA), literature review, and consensus by the PCA assessment working party of the Atypical Alzheimer's Disease PIA.RESULTSSurvey results revealed robust agreement for assessment tool preferences for PCA features, and many respondents indicated that they reserve assessment tools for use only when PCA is suspected. For some PCA features, curated tools were preferred over validated battery tools, particularly for the office visit. Consensus recommendations superseded survey preferences for two core cognitive features within the 2017 PCA diagnostic criteria.DISCUSSIONThese consensus recommendations provide an evaluation framework for PCA clinical features and can facilitate timely and accurate recognition and diagnosis of PCA. Broader use of these tools should be sought, and development and validation of novel PCA clinical outcome assessments are needed to improve our understanding of atypical AD and other dementias and support the inclusion of those with PCA in treatment trials.

Publisher

Wiley

Subject

Psychiatry and Mental health,Neurology (clinical)

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