Posterior Cortical Atrophy

What is Posterior Cortical Atrophy?

Posterior Cortical Atrophy (PCA) refers to progressive degeneration of the outer layer of the brain (cortex). A possible variant of Alzheimer‘s disease, PCA may affect anywhere from 5 to 15 percent of patients with Alzheimer’s, although there are no definitive stats available to confirm the connection.

What are the Symptoms of Posterior Cortical Atrophy?

No standard diagnostic process exists for determining if someone has PCA. Consequently, it is often undetected or lumped in with symptoms of dementia or other conditions. PCA is frequently misdiagnosed since patients typically go to an eye doctor after experiencing vision-related symptoms and a condition initiating in the brain isn’t usually on the radar.

Possible symptoms include:

  • Progressive difficulty with vision
  • Trouble judging distances
  • Difficulty telling the difference between moving and stationary objects
  • Hallucinations
  • Difficulty with math or spelling
  • Anxiety
  • Memory issues (in later stages)

Posterior Cortical Atrophy Causes

Posterior cortical atrophy is caused by the shrinkage of a specific part of the brain. The outer layer of the brain, also called the cortical layer, is the “thinking” layer. The back part of this layer is what causes atrophies in this type of dementia. The brain shrinkage is caused by amyloid plaques accumulating in certain areas of the brain. In addition, there will be a buildup of neurofibrillary tangles. As these tangles and plaques continue to build up, the brain is damaged. This causes portions of it to begin to shrink. The back part of the outer region of the brain is the area most affected, though other areas may be partially affected to varying degrees.

PCA has not been shown to be a result of genetic mutations. The reason for the buildup of these tangles and plaques in the brain is unknown in most patients. However, in rare cases, certain neurodegenerative diseases such as Creutzfeldt-Jakob disease, Lewy body dementia and corticobasal degeneration, have been found to cause it. Some research has shown that Alzheimer’s disease and other forms of dementia have been found to cause PCA in a small percentage of those who develop this disease. Because of this association, some consider PCA to be an Alzheimer’s disease variant.

How is Posterior Cortical Atrophy Treated?

There are no specific treatment options available for PCA and nothing that’s known to be able to stop the progression of related symptoms. While there is no conclusive evidence to confirm it, there’s speculation drugs used to minimize Alzheimer’s symptoms may reduce effects of PCA.

Some people with PCA symptoms may respond well to:

  • Physical and occupational therapy
  • Cholinesterase inhibitors used to treat Alzheimer’s
  • Antidepressant medication (for anxiety or mood symptoms of PCA)

PCA causes changes in the brain similar to what happens with Alzheimer’s disease. This is why there is a suspected connection between the two conditions, although a different part of the brain is affected. There is no evidence to suggest AD is a contributing factor to the development or onset of Alzheimer’s or other forms of dementia. The average onset age of PCA is about ten years earlier than the average onset age of 65 for Alzheimer’s disease.

Posterior Cortical Atrophy Prevention

There is no known way to prevent this rare form of dementia or the Alzheimer’s disease that may be the underlying condition that leads to it. Because of the rarity of PCA, few clinical studies have been done on this disease and much remains unknown about how it begins and why it progresses. It is unknown whether PCA has the same risk factors as Alzheimer’s disease. Due to the fact that so little is known about how the condition begins, there are no known lifestyle changes that could reduce the risk factor of developing this disease.

Last Reviewed:
September 21, 2016
Last Updated:
January 11, 2018