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Chapter 16 - Posterior Cortical Atrophy

from Section 2 - The Dementias

Published online by Cambridge University Press:  17 November 2025

Bruce L. Miller
Affiliation:
University of California, San Francisco
Bradley F. Boeve
Affiliation:
Mayo Clinic, Minnesota
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Summary

Posterior cortical atrophy (PCA) is a rare neurodegenerative syndrome primarily affecting the parietal and occipital lobes. It is characterized by early deficits in visuospatial processing, numeracy, and literacy. The most common underlying pathology is Alzheimer’s disease (AD). PCA typically presents as a young onset form of dementia, with the majority of patients aged 50–65 years. The clinical presentation of PCA includes difficulties with visually and spatially complex tasks. Neuropsychological features include impairments in visuospatial and visuoperceptual processing. Neuroimaging studies show occipito-parietal atrophy and hypometabolism . There is limited evidence of a genetic component in PCAs. Pathologically, PCA is most commonly associated with AD. The consensus classification of PCA provides a framework for improved diagnosis and research. PCA shows overlap with other atypical AD presentations, and there is heterogeneity within the syndrome. The impact of PCA on everyday abilities and the subjective experience of individuals with PCA is not well understood. Management and support for PCA include pharmacological and nonpharmacological approaches .

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