TY - JOUR
T1 - Atypical Alzheimer’s disease
T2 - new insights into an overlapping spectrum between the language and visual variants
AU - Singh, Neha Atulkumar
AU - Graff-Radford, Jonathan
AU - Machulda, Mary M.
AU - Carlos, Arenn F.
AU - Schwarz, Christopher G.
AU - Senjem, Matthew L.
AU - Jack, Clifford R.
AU - Lowe, Val J.
AU - Josephs, Keith A.
AU - Whitwell, Jennifer L.
N1 - Publisher Copyright:
© The Author(s), under exclusive licence to Springer-Verlag GmbH Germany 2024.
PY - 2024
Y1 - 2024
N2 - Overlap between language and visual variants of atypical Alzheimer’s disease (AD) has been reported. However, the extent, frequency of overlap, and its neuroanatomical underpinnings remain unclear. Eighty-two biomarker-confirmed AD patients who presented with either predominant language (n = 34) or visuospatial/perceptual (n = 48) deficits underwent detailed clinical examinations, MRI, and [18F]flortaucipir-PET. Subgroups were defined based on language/visual testing and patterns of volume loss and tau uptake were assessed. 28% of the language group had visual dysfunction (marked in 8%), and 47% of the visual group had language impairment (marked in 26%). Progressive involvement of the parieto-occipital and frontal lobes was noted with greater visual impairment in the language group, and greater left parieto-temporal and frontal involvement with worsening language impairment in the visual group. Only 25% of our cohort showed a pure language or visual presentation, highlighting the high frequency of syndromic overlap in atypical AD and the diagnostic challenge of categorical phenotyping.
AB - Overlap between language and visual variants of atypical Alzheimer’s disease (AD) has been reported. However, the extent, frequency of overlap, and its neuroanatomical underpinnings remain unclear. Eighty-two biomarker-confirmed AD patients who presented with either predominant language (n = 34) or visuospatial/perceptual (n = 48) deficits underwent detailed clinical examinations, MRI, and [18F]flortaucipir-PET. Subgroups were defined based on language/visual testing and patterns of volume loss and tau uptake were assessed. 28% of the language group had visual dysfunction (marked in 8%), and 47% of the visual group had language impairment (marked in 26%). Progressive involvement of the parieto-occipital and frontal lobes was noted with greater visual impairment in the language group, and greater left parieto-temporal and frontal involvement with worsening language impairment in the visual group. Only 25% of our cohort showed a pure language or visual presentation, highlighting the high frequency of syndromic overlap in atypical AD and the diagnostic challenge of categorical phenotyping.
KW - Atypical Alzheimer’s disease
KW - Logopenic progressive aphasia
KW - MRI
KW - Posterior cortical atrophy
KW - Tau PET
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U2 - 10.1007/s00415-024-12297-1
DO - 10.1007/s00415-024-12297-1
M3 - Article
AN - SCOPUS:85189149124
SN - 0340-5354
JO - Journal of Neurology
JF - Journal of Neurology
ER -