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Focal cortical presentations of Alzheimer's disease
Abstract
To determine the frequency of Alzheimer's disease (AD) pathology in patients presenting with progressive focal cortical syndromes, notably posterior cortical atrophy (PCA), corticobasal syndrome (CBS), behavioural variant frontotemporal dementia (bvFTD), progressive non-fluent aphasia (PNFA) (or a mixed aphasia) and semantic dementia (SD); and to compare the age of onset, evolution and prognosis in patients with focal cortical presentations of AD versus more typical AD and those with non AD pathology. From a total of 200 patients with comprehensive prospective clinical and pathological data we selected 120 : 100 consecutive cases with focal cortical syndromes and 20 with clinically typical AD. Clinical files were reviewed blind to pathological diagnosis. Of the 100 patients with focal syndromes, 34 had AD as the primary pathological diagnosis with the following distribution across clinical subtypes: all 7 of the PCA (100%); 6 of 12 with CBS (50%); 2 of 28 with bvFTD (7.1%); 12 of 26 with PNFA (44.1%); 5 of 7 with mixed aphasia (71.4%) and 2 of 20 with SD (10%). Of 20 with clinically typical AD, 19 had pathological AD. Age at both onset and death was greater in the atypical AD cases than those with non-AD pathology, although survival was equivalent. AD is a much commoner cause of focal cortical syndromes than previously recognised, particularly in PCA, PNFA and CBS, but rarely causes SD or bvFTD. The focal syndrome may remain pure for many years. Patients with atypical AD tend…
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“While not apparent in our cases, studies have demonstrated that executive or behavioral dysfunction typically develop after memory deficits in fvAD [1, 22, 23].”
From Diagnosing the frontal variant of Alzheimer’s disease: a clinician’s yellow brick road (2017) · cites this paper as [1]
In the citing paper
“Some studies have suggested that fvAD accounts for approximately 2–3% of AD, [1, 2]”
From Diagnosing the frontal variant of Alzheimer’s disease: a clinician’s yellow brick road (2017) · cites this paper as [1]
In the citing paper
“Conversely, in fvAD memory impairment is the first abnormality in up to 85% of patients (Fig. 4), with the remainder developing memory impairment within 3 years from symptom onset [1, 22, 23].”
From Diagnosing the frontal variant of Alzheimer’s disease: a clinician’s yellow brick road (2017) · cites this paper as [1]
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“onsistent with this and in a parallel theme in the literature, an typical language variant of AD overlapping closely with the LPA yndrome has been described, largely based on retrospective correation with post-mortem data (Alladi et al., 2007; Galton, Patterson, uereb, & Hodges, 2000).”
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“Examination of focal presentations of AD found it to be the primary diagnosis in 7% of bvFTD, 44% of naPPA, 10% of svPPA, and 50% of the extrapyramidal and cognitive disorder, corticobasal syndrome (CBS) patients (Alladi et al., 2007).”
BackgroundLing, H., de Silva, R., Massey, L. A., Courtney, R. J., Hondhamuni, G., Bajaj, N. P. S., Lowe, J. S., Holton, J. L., Lees, A. J., & Révész, T. (2013) · Neuropathology and Applied Neurobiology · doi:10.1111/nan.12037 · Cited by 97
Executive deficits detected in mild Alzheimer's disease using the antisaccade task
Kaufman, L. D., Pratt, J., Levine, B., & Black, S. (2012) · Brain and Behavior · doi:10.1002/brb3.28 · Cited by 96
“…is the most prominent feature of AD; however, there is an increasing awareness that AD is heterogeneous and even early in the course can be associated with varying degrees of impairment in the visuospatial, executive, and language domains (Buck et al. 1997; Galton et al. 2000; Alladi et al. 2007).”
BackgroundUsing Pittsburgh Compound B for In Vivo PET Imaging of Fibrillar Amyloid-Beta
Cohen, A. D., Rabinovici, G. D., Mathis, C. A., Jagust, W. J., Klunk, W. E., & Ikonomović, M. D. (2012) · Advances in pharmacology · doi:10.1016/b978-0-12-394816-8.00002-7 · Cited by 103
“…logopenic-variant primary progressive aphasia (lvPPA), a language disorder characterized by difficulties with naming, word retrieval, and repetition— have been strongly associated with AD pathophysiology (Alladi et al., 2007; Gorno-Tempini et al., 2004; Mesulam et al., 2008; Tang-Wai et al., 2004).”
Rates of Amyloid Imaging Positivity in Patients With Primary Progressive Aphasia
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How the cognitive reserve interacts with β-amyloid deposition in mitigating FDG metabolism
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Shining a light on posterior cortical atrophy
Crutch, S. J., Schott, J. M., Rabinovici, G. D., Boeve, B. F., Cappa, S. F., Dickerson, B. C., Dubois, B., Graff‐Radford, N. R., Krolak‐Salmon, P., Lehmann, M., et al. (2012) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2012.11.004 · Cited by 92
“80%) of PCA patients are found to have AD pathology as the cause of dementia at autopsy [8,11,12].”
CSF biomarkers in posterior cortical atrophy
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MethodThe logopenic variant of primary progressive aphasia
Henry, M., & Gorno-Tempini, M. (2010) · Current Opinion in Neurology · doi:10.1097/wco.0b013e32833fb93e · Cited by 88
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“9×4mmresolution; (7) task-free functionalMRI, T2*-weighted gradient echo–echo planar sequence with TR/TE = 600/30 ms, flip”
de Souza, L. C., Marie Chupin, A., Bertoux, M., Lehéricy, S., Dubois, B., Lamari, F., Ber, I. L., Bottlaender, M., Olivier Colliot, A., & Sarazin, M. (2013) · Journal of Alzheimer s Disease · doi:10.3233/jad-122293 · Cited by 91
“However, these results were limited by (a) the small number of FTD patients [14, 15]; (b) the fact that semantic dementia (SD) was pooled with behavioral variant FTD (bvFTD) [18], where SD and bvFTD have distinct clinical and imaging features; and (c) the possible inclusion of patients with frontal presentation of AD…”
Impairments of auditory scene analysis in Alzheimer's disease
Goll, J. C., Kim, L. G., Ridgway, G. R., Hailstone, J. C., Lehmann, M., Buckley, A. H., Crutch, S. J., & Warren, J. D. (2011) · Brain · doi:10.1093/brain/awr260 · Cited by 91
“It is increasingly recognized that Alzheimer’s disease is a heterogeneous entity (Cummings, 2000; Alladi et al., 2007; Snowden et al., 2007; Stopford et al., 2007, 2008, 2010), and this heterogeneity may be at least partly stratified by age (Stopford et al.”
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Sensitivity and specificity of FTDC criteria for behavioral variant frontotemporal dementia
Harris, J. M., Gall, C., Thompson, J. C., Richardson, A. M. T., Neary, D., du Plessis, D., Pal, P., Mann, D. M. A., Snowden, J. S., & Jones, M. (2013) · Neurology · doi:10.1212/wnl.0b013e318292a342 · Cited by 83
Dopamine Transporter SPECT Imaging in Corticobasal Syndrome
Cilia, R., Rossi, C. A., Frosini, D., Volterrani, D., Siri, C., Pagni, C., Benti, R., Pezzoli, G., Bonuccelli, U., Antonini, A., et al. (2011) · PLoS ONE · doi:10.1371/journal.pone.0018301 · Cited by 92
“Indeed, some CBS patients with normal FP-CIT binding might still turn out to be focal cortical variants of other dementia than CBD [3,7,10,46,47,54–59], because clinical features and the distribution of pathological lesions are closely associated whatever the histologic nature [3,4,9,14].”
BackgroundChételat, G., Ossenkoppele, R., Villemagne, V. L., Perrotin, A., Landeau, B., Mézenge, F., Jagust, W. J., Dore, V., Miller, B. L., Egret, S., et al. (2016) · Brain · doi:10.1093/brain/aww159 · Cited by 80
“, 2014), these patients also show significant clinical overlap with frontotemporal dementia-spectrum disorders (Alladi et al., 2007; Ossenkoppele et al., 2015b).”
BackgroundMolecular imaging in dementia: Past, present, and future
Laforce, R. J., Soucy, J., Sellami, L., Dallaire‐Théroux, C., Brunet, F., Bergeron, D., Miller, B. L., & Ossenkoppele, R. (2018) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2018.06.2855 · Cited by 88
“Although most cases of clinical CBS are associated with FTLD pathology (although not necessarily corticobasal degeneration), 25% to 50% of patients are found to have AD as the causative pathology postmortem [55,57,120].”
BackgroundInfluentialDifferences between Early and Late-Onset Alzheimer’s Disease in Neuropsychological Tests
Sá, F., Pinto, P., Cunha, C., Lemos, R., Letra, L., Simões, M., & Santana, I. (2012) · Front. Neur. · doi:10.3389/fneur.2012.00081 · Cited by 79
“Namely, AD could be the most frequent cause of Logopenic Progressive Aphasia, a subtype of PPA, clinically characterized by slow speech, sentence repetition, and comprehension deficits, with relative sparing of motor speech, grammar, and single-word comprehension (Gorno-Tempini et al., 2008).”
BackgroundRate of Change of Functional Abilities in Frontotemporal Dementia
Mioshi, E., & Hodges, J. R. (2009) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000255652 · Cited by 79
“In our study, we separated FTD in 3 variants and phenocopy cases, while prior studies have combined them all in one single group. SemDem patients start at similar levels of ability in comparison to PNFA, but show a much milder decline after 12 months. The accentuated deterioration in PNFA is somewhat surprising, given…”
ResultSelf-citationLaforce, R., & Rabinovici, G. D. (2011) · Alzheimer's Research & Therapy · doi:10.1186/alzrt93 · Cited by 79
“Distinguishing the two during life can be challeng ing due to clinical and anatomic overlap, and misdiagnosis rates of 10 to 40% are reported even in expert centers [75].”
BackgroundStructural brain imaging in frontotemporal dementia
Rohrer, J. D. (2011) · Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease · doi:10.1016/j.bbadis.2011.07.014 · Cited by 86
Alzheimer’s Disease: A Clinical Practice-Oriented Review
Alves, L., Correia, A. S., Miguel, R., Alegria, P., & Bugalho, P. (2012) · Frontiers in Neurology · doi:10.3389/fneur.2012.00063 · Cited by 74
“Half of the cortical basal syndrome (CBS) cases, about 40% of the patients with the non-fluent aphasia syndrome and a small percentage with behavioral FTLD and semantic dementia syndromes had AD pathology (Alladi et al., 2007).”
BackgroundInfluentialThe corticobasal syndrome–Alzheimer’s disease conundrum
Hassan, A., Whitwell, J. L., & Josephs, K. A. (2011) · Expert Review of Neurotherapeutics · doi:10.1586/ern.11.153 · Cited by 80
Formaglio, M., Costes, N., Seguin, J., Tholance, Y., Bars, D. L., Roullet‐Solignac, I., Mercier, B., Krolak‐Salmon, P., & Vighetto, A. (2011) · Journal of Neurology · doi:10.1007/s00415-011-6030-0 · Cited by 72
“diagnosis are concordant with neuropathological studies showing AD pathology in most PCA cases [2, 3, 9].”
BackgroundResultMetabolic profiling distinguishes three subtypes of Alzheimer's disease
Bredesen, D. E. (2015) · Aging · doi:10.18632/aging.100801 · Cited by 76
“Alzheimer’s disease presenting with non-amnestic features such as aphasia, partial Gerstmann’s syndrome, alexia, visual agnosia, or apraxias has been well described [16], but metabolic abnormalities distinguishing these atypical presentations have not been reported.”
BackgroundLost and Forgotten? Orientation Versus Memory in Alzheimer's Disease and Frontotemporal Dementia
Yew, B., Alladi, S., Mekala, S., Hodges, J. R., & Hornberger, M. (2012) · Journal of Alzheimer s Disease · doi:10.3233/jad-2012-120769 · Cited by 74
“This is an important point to address in future studies as the NINCDS-ADRDA criteria show only a poor differentiation of AD and FTD [28] and patients with behavioral symptoms may have underlying AD pathology [29].”
Self-citationVentral and dorsal visual streams in posterior cortical atrophy: A DT MRI study
Migliaccio, R., Agosta, F., Scola, E., Magnani, G., Cappa, S. F., Pagani, E., Canu, E., Comı, G., Falini, A., Gorno‐Tempini, M. L., et al. (2012) · Neurobiology of Aging · doi:10.1016/j.neurobiolaging.2011.12.025 · Cited by 76
“Our results, showing such similarities between PCA and AD, are consistent with previous studies (Alladi et al., 2007; Migliaccio et al., 2009) that considered PCA as an atypical clinical manifestation of AD.”
BackgroundMethodResultInfluentialUpdate on amyloid imaging: From healthy aging to Alzheimer’s disease
Wolk, D. A., & Klunk, W. E. (2009) · Current Neurology and Neuroscience Reports · doi:10.1007/s11910-009-0051-4 · Cited by 65
“These clinical phenotypes are all associated with a proportion of patients who have primarily AD pathology (Alladi et al., 2007).”
BackgroundInfluentialNeocortical origin and progression of gray matter atrophy in nonamnestic Alzheimer's disease
Phillips, J. S., Da Re, F., Dratch, L., Xie, S. X., Irwin, D. J., McMillan, C. T., Vaishnavi, S. N., Ferrarese, C., Lee, E. B., Shaw, L. M., et al. (2018) · Neurobiology of Aging · doi:10.1016/j.neurobiolaging.2017.11.008 · Cited by 74
“NaAD phenotypes are characterized by an initial non-amnestic presentation, phenotypespecific cognitive impairment, and focal disease in associated neocortical areas (Alladi et al., 2007; DuBois et al., 2014; Mendez et al., 2012).”
Approach to atypical Alzheimer’s disease and case studies of the major subtypes
Dickerson, B. C., McGinnis, S. M., Xia, C., Price, B. H., Atri, A., Murray, M. E., Mendez, M. F., & Wolk, D. A. (2017) · CNS Spectrums · doi:10.1017/s109285291600047x · Cited by 86
“Approximately one-third of patients with AD and onset of symptoms before age 65 present atypically with primary cognitive dysfunction in a domain other than episodic memory,(9,10) a phenomenon less common but still encountered in late-onset AD as well.(11) Clinical diagnosis is frequently delayed in cases with atypica…”
BackgroundBrain networks in posterior cortical atrophy: A single case tractography study and literature review
Migliaccio, R., Agosta, F., Toba, M. N., Samri, D., Corlier, F. W., de Souza, L. C., Marie Chupin, A., Sharman, M. A., Gorno‐Tempini, M. L., Dubois, B., et al. (2011) · Cortex · doi:10.1016/j.cortex.2011.10.002 · Cited by 72
“…of the lack of memory impairment as core of the syndrome, pathological series have found that the majority of PCA patients have senile plaques and neurofibrillary tangles, both hallmarks of AD, at autopsy (von Gunten et al., 2006; Renner et al., 2004; Tang-Wai et al., 2004; Alladi et al., 2007).”
BackgroundWhite Matter Degeneration in Atypical Alzheimer Disease
Caso, F., Agosta, F., Mattavelli, D., Migliaccio, R., Canu, E., Magnani, G., Marcone, A., Copetti, M., Falautano, M., Comı, G., et al. (2015) · Radiology · doi:10.1148/radiol.2015142766 · Cited by 69
Tau-induced pathology in epilepsy and dementia: notions from patients and animal models.
Sánchez, M., García-Cabrero, A., Sánchez-Elexpuru, G., Burgos, D., & Serratosa, J. (2018) · International Journal of Molecular Sciences · doi:10.3390/ijms19041092 · Cited by 68
“Myoclonus presents more frequently in atypical forms of AD with major neocortical affectation [15,16], as well as in other atypical forms of AD with other dementia symptoms and parkinsonism [17–20].”
BackgroundDay, G. S., Gordon, B. A., Jackson, K., Christensen, J. J., Ponisio, M. R., Su, Y., Ances, B. M., Benzinger, T. L. S., & Morris, J. C. (2017) · Alzheimer Disease & Associated Disorders · doi:10.1097/wad.0000000000000196 · Cited by 69
“27) (N=42)w,z Interval between florbetapir and flortaucipir imaging, median (range) (d) 9 (1-26) (N=5) 70 (7-310) (N=9) 145 (8-258) (N=42)z”
Paterson, R. W., Heywood, W., Heslegrave, A., Magdalinou, N. K., Andréasson, U., Sirka, E., Bliss, E., Slattery, C. F., Toombs, J., Svensson, J., et al. (2016) · Translational Psychiatry · doi:10.1038/tp.2016.194 · Cited by 65
Clinical and research diagnostic criteria for Alzheimer's disease
Sarazin, M., de Souza, L. C., Lehéricy, S., & Dubois, B. (2012) · Neuroimaging Clinics of North America · doi:10.1016/j.nic.2011.11.004 · Cited by 64
“Moreover, focal atypical presentation of AD, such as posterior cortical atrophy and logopenic aphasia, have been described in neuropathologic studies.(59) By using physiopathologic markers, such as CSF biomarkers and (11)C-PiB-PET, it is now possible to identify in vivo an underlying process similar to that observed i…”
BackgroundComparative semantic profiles in semantic dementia and Alzheimer’s disease
Libon, D. J., Rascovsky, K., Powers, J., Irwin, D. J., Boller, A., Weinberg, D. D., McMillan, C. T., & Grossman, M. (2013) · Brain · doi:10.1093/brain/awt165 · Cited by 59
“Indeed, the anatomical distribution of disease in Alzheimer’s disease is highly variable, resulting in specific syndromes depending on the anatomical distribution of disease such as logopenic variant PPA, posterior cortical atrophy, and others (Alladi et al., 2007).”
BackgroundSajjadi, S., Acosta-Cabronero, J., Patterson, K., Diaz-de-Grenu, L. Z., Williams, G. B., & Nestor, P. (2013) · Brain : a journal of neurology · doi:10.1093/brain/awt118 · Cited by 63
“BRAIN A JOURNAL OF NEUROLOGY Diffusion tensor magnetic resonance imaging for single subject diagnosis in neurodegenerative diseases”
BackgroundSelf-citationCanu, E., Agosta, F., Mandic-Stojmenovic, G., Stojković, T., Stefanova, E., Inuggi, A., Imperiale, F., Copetti, M., Kostic, V. S., & Filippi, M. (2017) · NeuroImage: Clinical · doi:10.1016/j.nicl.2017.05.018 · Cited by 62
“A number of studies showed that several path-proven AD patients received in vita a diagnosis of bvFTD, or vice versa, with the majority of misclassified cases having an early age of onset and/or neuropsychiatric symptoms (Alladi et al., 2007; Harris et al., 2013; Mendez et al., 2013; Rabinovici et al., 2007; Rascovsky…”
New approaches to the treatment of frontotemporal lobar degeneration
Vossel, K. A., & Miller, B. L. (2008) · Current Opinion in Neurology · doi:10.1097/wco.0b013e328318444d · Cited by 68
18 F-Flortaucipir PET/MRI Correlations in Nonamnestic and Amnestic Variants of Alzheimer Disease
Nasrallah, I. M., Chen, Y. J., Hsieh, M.-K., Phillips, J. S., Ternes, K., Stockbower, G. E., Sheline, Y., McMillan, C. T., Grossman, M., & Wolk, D. A. (2018) · Journal of Nuclear Medicine · doi:10.2967/jnumed.117.194282 · Cited by 60
“Using clinical diagnostic criteria, the patients were phenotypically classified as amnestic EOAD (n 5 6) (23), lvPPA (n 5 4) (24), or PCA (n 5 5) (3,25); classification was masked to 18F-flortaucipir PET findings and quantitative GM atrophy.”
MethodFronto-Striatal Atrophy in Behavioral Variant Frontotemporal Dementia and Alzheimer’s Disease
Bertoux, M., O’Callaghan, C., Flanagan, E. C., Hodges, J. R., & Hornberger, M. (2015) · Frontiers in Neurology · doi:10.3389/fneur.2015.00147 · Cited by 72
“In particular, a percentage of AD patients present with prefrontal deficits (60), which can make them appear clinically very similar to bvFTD (61).”
BackgroundSelf-citationFrontotemporal dementia and primary progressive aphasia, a review
Kirshner, H. S. (2014) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s38821 · Cited by 75
“Although the term initially implied a pathology other than AD, we now must consider that some cases may have a syndrome of PPA but a pathological diagnosis of AD.”
InfluentialDistribution of Pathology in Frontal Variant Alzheimer's Disease
Blennerhassett, R. C., Lillo, P., Halliday, G. M., Hodges, J. R., & Kril, J. J. (2014) · Journal of Alzheimer s Disease · doi:10.3233/jad-131241 · Cited by 74
“These results suggest no difference medial temporal lobe pathology between the two”
Self-citationCognitive decline in logopenic aphasia
Leyton, C. E., Hsieh, S., Mioshi, E., & Hodges, J. R. (2013) · Neurology · doi:10.1212/wnl.0b013e318285c15b · Cited by 92
“Recently an International Consensus Group published diagnostic criteria for variants of primary progressive aphasia (PPA) distinguished by their pattern of language deficits in semantic (sv-PPA), nonfluent/agrammatic (nfv-PPA), and logopenic (lv-PPA) variants.1 The latter, lv-PPA, is characterized by the concurrence o…”
BackgroundInfluentialSelf-citationPrimary Progressive Aphasia and Alzheimer’s Disease: Brief History, Recent Evidence
Kirshner, H. (2012) · Current Neurology and Neuroscience Reports · doi:10.1007/s11910-012-0307-2 · Cited by 57
“Several groups have reported amyloid binding on PET imaging in cases of PPA,most commonly in the LPAvariant [41, 45, 58–63], but, occasionally, in the SD variant [45, 58, 59, 63], and even, rarely, in the PFNAvariant [58, 61].”
Ohm, D. T., Fought, A. J., Martersteck, A., Coventry, C., Sridhar, J., Gefen, T. D., Weıntraub, S., Bigio, E. H., Mesulam, M. M., Rogalski, E. J., et al. (2020) · Brain Pathology · doi:10.1111/bpa.12902 · Cited by 59
“The aphasic variant of AD, also known as primary progressive aphasia caused by AD neuropathology (PPA-AD) (1, 26, 40, 50, 53, 66, 69, 87), is a language dementia syndrome characterized by an asymmetric pattern of cortical atrophy concentrated to the language dominant hemisphere (51, 64, 65, 67).”
Harciarek, M., & Kertesz, A. (2011) · Neuropsychology Review · doi:10.1007/s11065-011-9175-9 · Cited by 62
“It is worth mentioning that Alzheimer’s first patient was also aphasic (Alzheimer 1907), suggesting that language impairment may also be a component of Alzheimer’s disease (AD).”
BackgroundDelusions in frontotemporal lobar degeneration
Omar, R., Sampson, E., Loy, C., Mummery, C., Fox, N. C., Rossor, M., & Warren, J. (2009) · Journal of Neurology · doi:10.1007/s00415-009-0128-7 · Cited by 56
“While the SD syndrome is unusual as a presentation of AD [15], the presence of atypical features (as here) may increase the likelihood of AD pathology.”
BackgroundMa, D., Lu, D., Popuri, K., Wang, L., Beg, M. F., & Initiative, A. D. N. (2020) · Frontiers in Neuroscience · doi:10.3389/fnins.2020.00853 · Cited by 56
“This is due to the similarities in their clinical presentation, cognitive domains impairment, brain atrophy, and progressive alterations in language ability, behavior, and personality (Neary et al., 2005; Alladi et al., 2007; Womack et al., 2011).”
BackgroundFlexible wireless powered drug delivery system for targeted administration on cerebral cortex
Sung, S. H., Kim, Y. S., Joe, D. J., Mun, B. H., You, B. K., Keum, D. H., Hahn, S. K., Berggren, M., Kim, D., & Lee, K. J. (2018) · Nano Energy · doi:10.1016/j.nanoen.2018.06.015 · Cited by 55
Three-Class Differential Diagnosis among Alzheimer Disease, Frontotemporal Dementia, and Controls
Raamana, P. R., Rosen, H., Miller, B., Weiner, M. W., Wang, L., & Beg, M. F. (2014) · Frontiers in Neurology · doi:10.3389/fneur.2014.00071 · Cited by 55
“Many patients with pathologically confirmed FTD had been clinically diagnosed with AD during life (7) and 10–40% of patients clinically diagnosed with FTD are found to have AD postmortem (8).”
BackgroundLate-onset Alzheimer disease genetic variants in posterior cortical atrophy and posterior AD
Carrasquillo, M. M., Khan, Q. U. A., Murray, M. E., Krishnan, S., Aakre, J. A., Pankratz, V. S., Nguyen, T., Ma, L., Bisceglio, G. D., Petersen, R. C., et al. (2014) · Neurology · doi:10.1212/wnl.0000000000000335 · Cited by 61
Evolution of the diagnostic criteria for degenerative and cognitive disorders
López, O. L., McDade, E., Riverol, M., & Becker, J. T. (2011) · Current Opinion in Neurology · doi:10.1097/wco.0b013e32834cd45b · Cited by 58
Goossens, J., Bjerke, M., Mossevelde, S. V., den Bossche, T. V., Goeman, J., Vil, B. B. D., Sieben, A., Martin, J., Cras, P. P., Deyn, P. P. D., et al. (2018) · Alzheimer s Research & Therapy · doi:10.1186/s13195-018-0364-0 · Cited by 59
Clinico-Pathological Correlations of the Most Common Neurodegenerative Dementias
Taipa, R. J. F., Pinho, J., & Pires, M. M. (2012) · Frontiers in Neurology · doi:10.3389/fneur.2012.00068 · Cited by 54
“In the previously mentioned cohort of focal dementia syndromes, among 28 patients with FLS, two had pathological www.frontiersin.org May 2012 | Volume 3 | Article 68 | 3 findings consistent with AD (Alladi et al., 2007).”
BackgroundInfluentialDiagnosis and Management of Posterior Cortical Atrophy
Yong, K. X. X., Graff-Radford, J., Ahmed, S., Chapleau, M., Ossenkoppele, R., Putcha, D., Rabinovici, G. D., Suarez-Gonzalez, A., Schott, J. M., Crutch, S., et al. (2023) · Current Treatment Options in Neurology · doi:10.1007/s11940-022-00745-0 · Cited by 51
Neuropsychiatric Symptoms in Posterior Cortical Atrophy and Alzheimer Disease
Suárez-González, A., Crutch, S., Franco-Macías, E., & Gil-Neciga, E. (2016) · Journal of Geriatric Psychiatry and Neurology · doi:10.1177/0891988715606229 · Cited by 51
CSF Alzheimer's disease-like pattern in corticobasal syndrome: evidence for a distinct disorder
Borroni, B., Premi, E., Agosti, C., Alberici, A., Cerini, C., Archetti, S., Lanari, A., Paghera, B., Lucchini, S., Caimi, L., et al. (2011) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp.2010.221853 · Cited by 47
Visual Dysfunction in Posterior Cortical Atrophy
da Silva, M. N. M., Millington, R. S., Bridge, H., James-Galton, M., & Plant, G. T. (2017) · Frontiers in Neurology · doi:10.3389/fneur.2017.00389 · Cited by 56
“AD, however, remains the single dominant cause, accounting for 62–100% of the cases in the largest cohorts (6, 7, 9).”
BackgroundActivities of Daily Living in Behavioral Variant Frontotemporal Dementia
Mioshi, E., Kipps, C., & Hodges, J. R. (2009) · Alzheimer Disease & Associated Disorders · doi:10.1097/wad.0b013e318182d293 · Cited by 44
“Their level of impairment is greater than in Alzheimer disease (AD), even after controlling for age and length of disease.3 Moreover, their rate of deterioration seems to be faster than AD.5 It remains unclear why the bv-FTD group is so markedly impaired.”
BackgroundSelf-citationBensaïdane, M. R., Beauregard, J., Poulin, S. P., Buteau, F.-A., Guimond, J. V., Bergeron, D., Verret, L., Fortin, M., Houde, M., Bouchard, R. W., et al. (2016) · Journal of Alzheimer s Disease · doi:10.3233/jad-151180 · Cited by 50
Amyloid Imaging in Atypical Presentations of Alzheimer’s Disease
Wolk, D. A. (2013) · Current Neurology and Neuroscience Reports · doi:10.1007/s11910-013-0412-x · Cited by 54
“Further, a number of clinicopathology series have suggested that phenotypes which are traditionally thought to be associated with non-AD dementia have a significant minority of cases associated with AD histopathologic features [36, 58].”
BackgroundResultInfluentialAmyloid imaging in dementias with atypical presentation
Wolk, D. A., Price, J. C., Madeira, C., Saxton, J. A., Snitz, B. E., López, O. L., Mathis, C. A., Klunk, W. E., & DeKosky, S. T. (2012) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2011.07.003 · Cited by 51
“For example, in the series by Alladi et al [3], more than 40% of patients with progressive nonfluent aphasia had AD pathology rather than the expected frontotemporal lobar degeneration pathology.”
BackgroundAssessment of mild dementia with amyloid and dopamine terminal positron emission tomography
Burke, J. F., Albin, R. L., Koeppe, R. A., Giordani, B., Kilbourn, M. R., Gilman, S., & Frey, K. A. (2011) · Brain · doi:10.1093/brain/awr089 · Cited by 48
Brain Changes within the Visuo-Spatial Attentional Network in Posterior Cortical Atrophy
Cerami, C., Crespi, C., Rosa, P. A. D., Dodich, A., Marcone, A., Magnani, G., Coppi, E., Falini, A., Cappa, S. F., & Perani, D. (2014) · Journal of Alzheimer s Disease · doi:10.3233/jad-141275 · Cited by 48
“The diagnosis was based on clinical history, neurological evaluation, neuropsychological assessment, and neuroimaging findings [1, 19, 20].”
MethodKaerst, L., Kuhlmann, A., Wedekind, D., Stoeck, K., Lange, P., & Zerr, I. (2013) · Journal of Alzheimer s Disease · doi:10.3233/jad-130995 · Cited by 53
“who described 20 patients with clinically typical AD, of whom 19 could be verified by pathology [24].”
BackgroundAn exploration of cognitive subgroups in Alzheimer’s disease
Davidson, J. E., Irizarry, M. C., Bray, B. C., Wetten, S., Galwey, N. W., Gibson, R. A., BORRIE, M. J., Delisle, R. G., Feldman, H., Hsiung, G. R., et al. (2009) · Journal of the International Neuropsychological Society · doi:10.1017/s1355617709991160 · Cited by 47
“AD primarily presents as an amnestic syndrome in contrast to other dementias such as frontotemporal dementia which may present with prominent speech or behavioral disturbances (Alladi et al., 2007 ).”
BackgroundResultInfluentialDivergent patterns of TDP‐43 and tau pathologies in primary progressive aphasia
Giannini, L. A. A., Xie, S. X., McMillan, C. T., Liang, M., Williams, A., Jester, C., Rascovsky, K., Wolk, D. A., Ash, S., Lee, E. B., et al. (2019) · Annals of Neurology · doi:10.1002/ana.25465 · Cited by 52
“Finally, AD pathology may mimic any of the PPA syndromes.(3,4,6) These factors limit the utility of current clinical variant criteria(7) for predicting underlying neuropathology.”
BackgroundCollins, J. D., Henley, S. M. D., & Gonzalez, A. S. (2020) · International Psychogeriatrics · doi:10.1017/s1041610220001118 · Cited by 65
Latorre, A., Rocchi, L., Berardelli, A., Bhatia, K., & Rothwell, J. (2019) · Movement Disorders · doi:10.1002/mds.27736 · Cited by 44
Patterns of decline in naming and semantic knowledge in primary progressive aphasia
Sebastian, R., Thompson, C. B., Wang, N., Wright, A. E., Meyer, A. M., Friedman, R. B., Hillis, A. E., & Tippett, D. C. (2018) · Aphasiology · doi:10.1080/02687038.2018.1490388 · Cited by 47
“Less commonly associated disease pathologies are AD pathology (Alladi et al., 2007) and Pick bodies (Davies et al., 2005).”
BackgroundBoncoraglio, G. B., Piazza, F., Savoiardo, M., Farina, L., DiFrancesco, J. C., Prioni, S., Tagliavini, F., Parati, E. A., & Giaccone, G. (2015) · Journal of Alzheimer s Disease · doi:10.3233/jad-142376 · Cited by 45
Rankin, K. P., Mayo, M. C., Seeley, W. W., Lee, S. E., Rabinovici, G. D., Gorno‐Tempini, M. L., Boxer, A. L., Weiner, M. W., Trojanowski, J. Q., DeArmond, S. J., et al. (2011) · Journal of Molecular Neuroscience · doi:10.1007/s12031-011-9615-2 · Cited by 45
Functional Connectivity of Ventral and Dorsal Visual Streams in Posterior Cortical Atrophy
Migliaccio, R., Galléa, C., Kas, A., Perlbarg, V., Samri, D., Trotta, L., Michon, A., Lacomblez, L., Dubois, B., Lehéricy, S., et al. (2016) · Journal of Alzheimer s Disease · doi:10.3233/jad-150934 · Cited by 51
“Following criteria proposed by McMonagle [3], and modified by Alladi [16] were applied: 1) presentation with progressive visual or visuospatial impairment in the absence of ophthalmologic impairment; 2) evidence”
MethodPaca, M. J. T., Parra, D. R. P., Mena, N. V. P., & Galarza, A. G. A. (2016) · Revista de medicina de la Universidad de Navarra · doi:10.1016/s0212-5382(08)70776-3 · Cited by 43
18F-Florbetapir PET in Patients with Frontotemporal Dementia and Alzheimer Disease
Kobylecki, C., Langheinrich, T., Hinz, R., Vardy, E. R. L. C., Brown, G. D., Martino, M. E., Haense, C., Richardson, A. M. T., Gerhard, A., Anton‐Rodriguez, J., et al. (2015) · Journal of Nuclear Medicine · doi:10.2967/jnumed.114.147454 · Cited by 48
“Patients with pathologically confirmed AD may have behavioral features of FTD at presentation, although they tend to develop neuropsychologic features, such as visuospatial impairment, characteristic of AD during the disease course (4,27).”
BackgroundCSF-Tau and CSF-Aβ1–42 in Posterior Cortical Atrophy
Baumann, T. P., Duyar, H., Sollberger, M., Kuhle, J., Regeniter, A., Gomez-Mancilla, B., Schmidtke, K., & Monsch, A. (2010) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000314679 · Cited by 43
Diagnostic biomarkers in Alzheimer’s disease
Andersen, E., Casteigne, B., Chapman, W. D., Creed, A., Foster, F., Lapins, A., Shatz, R., & Sawyer, R. P. (2021) · Biomarkers in Neuropsychiatry · doi:10.1016/j.bionps.2021.100041 · Cited by 42
Biomarkers in frontotemporal lobar degenerations—Progress and challenges
Hu, W. T., Trojanowski, J. Q., & Shaw, L. M. (2011) · Progress in Neurobiology · doi:10.1016/j.pneurobio.2011.04.012 · Cited by 42
“(Alladi et al., 2007; Forman et al., 2006; Hu et al., 2010e; Mesulam et al., 2008) Further characterization of their non-fluency through detailed language examinations can identify patients who are more likely to have underlying pathology of AD rather than a FTLD,(Gorno-Tempini et al., 2008; Hu et…”
BackgroundTisdall, M. D., Ohm, D. T., Lobrovich, R., Das, S. R., Mizsei, G., Prabhakaran, K., Ittyerah, R., Lim, S., McMillan, C. T., Wolk, D. A., et al. (2021) · NeuroImage Clinical · doi:10.1016/j.nicl.2021.102913 · Cited by 41
“(Alladi et al., 2007; Ossenkoppele et al., 2015; Townley et al., 2020) Our cases had a prominent social disorder consistent with bvFTD (Table 1) and thus would not meet these new proposed clinical criteria for dysexecutive ADNC.”
Therriault, J., Pascoal, T. A., Savard, M., Benedet, A. L., Chamoun, M., Tissot, C., Lussier, F. Z., Kang, M. S., Thomas, E. M., Terada, T., et al. (2020) · Neurology · doi:10.1212/wnl.0000000000011081 · Cited by 53
“Autopsy studies provide evidence that focal cortical syndromes such as posterior cortical atrophy and logopenic primary progressive aphasia can result from AD pathology.(5) Recent in vivo molecular imaging studies have extended this concept by providing evidence that the distribution of tau pathology is more closely r…”
BackgroundMolho, E., Agarwal, N., Regan, K., Higgins, D., & Factor, S. (2009) · Movement Disorders · doi:10.1002/mds.22622 · Cited by 42
Chapleau, M., Joie, R. L., Yong, K. X. X., Agosta, F., Allen, I. E., Apostolova, L. G., Best, J., Boon, B. D. C., Crutch, S. J., Filippi, M., et al. (2024) · The Lancet Neurology · doi:10.1016/s1474-4422(23)00414-3 · Cited by 73
Self-citationGoossens, J., Vanmechelen, E., Trojanowski, J. Q., Lee, V. M. ‐., Broeckhoven, C. V., van der Zee, J., & Engelborghs, S. (2015) · Acta Neuropathologica Communications · doi:10.1186/s40478-015-0195-1 · Cited by 43
“Moreover, it should be noted that up to 25% of clinical FTLD is actually due to atypical presentation of AD pathology [14,24].”
BackgroundDiagnosing the frontal variant of Alzheimer’s disease: a clinician’s yellow brick road
Sawyer, R. P., Rodriguez-Porcel, F., Hagen, M., Shatz, R., & Espay, A. J. (2017) · Journal of Clinical Movement Disorders · doi:10.1186/s40734-017-0052-4 · Cited by 40
“These three cases highlight the extent to which behavioral abnormalities may overshadow cognitive impairment in fvAD, the lesser known focal variant of AD, leading to the clinical misdiagnosis of bvFTD.”
BackgroundResultInfluentialSeizure in Alzheimer’s Disease: An Underestimated Phenomenon
Asadollahi, M., Atazadeh, M., & Noroozıan, M. (2018) · American Journal of Alzheimer s Disease & Other Dementias® · doi:10.1177/1533317518813551 · Cited by 56
Sha, S. J., Ghosh, P. M., Lee, S. E., Corbetta-Rastelli, C. M., Jagust, W., Kornak, J., Rankin, K. P., Grinberg, L. T., Vinters, H. V., Mendez, M. F., et al. (2015) · Alzheimer s Research & Therapy · doi:10.1186/s13195-014-0093-y · Cited by 48
“Alzheimer’s disease (AD) is found to be the primary underlying pathology in approximately 25% of patients [4-8].”
BackgroundPathology in Primary Progressive Aphasia Syndromes
Harris, J., & Jones, M. S. (2014) · Current Neurology and Neuroscience Reports · doi:10.1007/s11910-014-0466-4 · Cited by 41
The Relationship Between Schizophrenia and Frontotemporal Dementia
Cooper, J. J., & Ovsiew, F. (2013) · Journal of Geriatric Psychiatry and Neurology · doi:10.1177/0891988713490992 · Cited by 40
“The finding of Alzheimer disease (AD) at autopsy occurs in a small minority of patients with FTD.(9) The term FTD is sometimes used narrowly to describe a progressive behavioral syndrome, now codified as bvFTD; this is the area of most interest in relation to schizophrenia.”
BackgroundAtypical Alzheimer Disease Variants
Polsinelli, A. J., & Apostolova, L. G. (2022) · Continuum · doi:10.1212/con.0000000000001082 · Cited by 39
Visuo-Spatial Imagery Impairment in Posterior Cortical Atrophy: A Cognitive and SPECT Study
Gardini, S., Concari, L., Pagliara, S., Ghetti, C., Venneri, A., & Caffarra, P. (2011) · Behavioural Neurology · doi:10.3233/ben-2011-0279 · Cited by 39
Stefano, F. D., Kas, A., Habert, M., Decazes, P., Lamari, F., Lista, S., Hampel, H. J., & Teichmann, M. (2016) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2016.02.005 · Cited by 42
“More recently, evolving evidence indicated, however, that CBS can be related to other neurodegenerative diseases as well, including Alzheimer’s disease (AD) [2].”
BackgroundLeuzy, A., Zimmer, E. R., DuBois, J. M., Pruessner, J. C., Cooperman, C., Soucy, J., Kostikov, A. P., Schirrmacher, E., Desautels, R., Gauthier, S. G., et al. (2015) · Brain Structure and Function · doi:10.1007/s00429-014-0978-3 · Cited by 38
“to differentiate on clinical grounds alone (Alladi et al. 2007), all patients underwent carbon-11 Pittsburgh Compound B ([(11)C]PiB) PET to rule out the presence of 1388 Brain Struct Funct (2016) 221:1387–1402”
BackgroundSpehl, T. S., Hellwig, S., Amtage, F., Weiller, C., Bormann, T., Weber, W., Hüll, M., Meyer, P. T., & Frings, L. (2014) · Journal of Neuroimaging · doi:10.1111/jon.12104 · Cited by 38
“(1) a visual analysis and threshold selection of plotted regional [F18]-FDG-uptake in direct comparison of PCA and DLB (18 patients) (2) application of a multinomial logistic regression with group’ as the dependent variable in comparison of PCA, DLB, and AD as a mixed clinical cohort (33 patients).”
MethodInfluentialNeuropathology of Alzheimer's Disease and its Variants
Duyckaerts, C. J., & Dickson, D. W. (2011) · Wiley eBooks · doi:10.1002/9781444341256.ch10 · Cited by 36
Tsai, P., Teng, E., Liu, C., & Mendez, M. F. (2011) · American Journal of Alzheimer s Disease & Other Dementias® · doi:10.1177/1533317511418955 · Cited by 51
“In a clinicopathological study of 100 cases of focal cortical syndromes, PCA was the clinical premorbid diagnosis in only 7 participants.(24) Clinicians and patients may therefore lack awareness for PCA.”
Metadata
- Authors
- Alladi, S., Xuereb, J., Bak, T., Nestor, P., Knibb, J., Patterson, K., & Hodges, J. R.
- Affiliations
- MRC Cognition and Brain Sciences Unit (GB)
- Corresponding author
- Alladi, S.
- Venue
- Brain
- Publisher
- Oxford University Press (OUP)
- Published
- 2007-10-01
- Volume
- 130
- Issue
- 10
- Pages
- 2636-2645
- ISSN
- 0006-8950 (ISSN-L)
- 1460-2156
- OpenAlex
- W2142244150
- Cited by
- 581
- References
- 0
- Citations by year
- 2026: 11 · 2025: 20 · 2024: 16 · 2023: 17 · 2022: 23 · 2021: 21 · 2020: 37 · 2019: 28 · 2018: 28 · 2017: 30 · 2016: 20 · 2015: 44 · 2014: 45 · 2013: 47 · 2012: 50
- FWCI
- 15.10
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Brain (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Medical Research Council
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Clinical Neurology › Amyotrophic Lateral Sclerosis Research
- Keywords
- Alzheimer's disease, posterior cortical atrophy, corticobasal syndrome, behavioral variant frontotemporal dementia, progressive nonfluent aphasia, semantic dementia, mixed aphasia, age of onset, prognosis, survival, neuropathology
- MeSH terms
- Aged, Alzheimer Disease, Atrophy, Cerebral Cortex, Cognition Disorders, Dementia, Diagnosis, Differential, Female, Humans, Male, Middle Aged, Prognosis, Syndrome, Survival Analysis, Age of Onset, Disease Progression, Aphasia, Primary Progressive
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