Abstract Details

Title Phenotypes and Biomarkers in Posterior Cortical Atrophy: Application of Consensus Clinical Diagnostic Criteria and the AT(N) Framework

Topic Aging, Dementia, and Behavioral Neurology

Presentation(s) P5 - Poster Session 5 (5:30 PM-6:30 PM)

Poster/Presentation
Number 9-026

Objective We operationalized applications of the recently published Posterior Cortical Atrophy (PCA) diagnostic criteria (Crutch Alzheimers Dement 2017;13:870-84) and National Institutes of Aging/Alzheimer’s Association “AT(N)” framework for classifying AD biomarkers (Jack Alzheimers Dement 2018;14:535-62) in subjects with possible PCA with the aim of determining how well our methods classified subjects with respect to syndromic diagnosis and suspected AD vs. non-AD neuropathology.

Background Consensus clinical diagnostic criteria and biomarker interpretation provide independent means of characterizing patients with posterior cortical atrophy (PCA), a neurodegenerative condition involving prominent early visual/spatial dysfunction usually associated with Alzheimer disease (AD) neuropathology.

Design/Methods A sample of n=15 subjects with possible PCA underwent detailed clinical and neuropsychological evaluations, high resolution MR imaging, amyloid PET imaging with ¹¹C-Pittsburgh Compound B (PiB), and tau PET imaging with ¹⁸F-flortaucipir (FTP). Clinical dementia rating scale (CDR) ratings were determined for standard domains, supplemental language and social/behavioral domains, and for a novel visual/spatial domain we developed for use in PCA research protocols.

Results In keeping with consensus diagnostic criteria, 12/15 subjects had prominent early visual/spatial dysfunction with relative sparing in memory, judgment and problem solving (JPS), language, and social/comportmental cognition reflected by domain ratings. Of the 3 who did not, one had equivalent ratings for visual/spatial and JPS, one had equivalent ratings for visual/spatial and memory, and the third had a progressive Gerstmann syndrome. 13/15 subjects were classified as A+T+(N)+ with respect to biomarkers. The other 2 subjects were classified as A-T-(N)+, one being the subject with the progressive Gerstmann syndrome and the other a subject who evolved to develop features of corticobasal syndrome and had a postmortem primary neuropathological diagnosis of corticobasal degeneration.

Conclusions We conclude that application of consensus clinical diagnostic criteria and of the AT(N) framework provide useful independent means of phenotyping and determining suspected AD vs. non-AD neuropathology, respectively.

Authors/Disclosures
Scott McGinnis, MD (Brigham and Women'S Hospital) PRESENTER	Dr. McGinnis has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai.
	No disclosure on file
Deepti Putcha, PhD (Massachusetts General Hospital)	No disclosure on file
Mark C. Eldaief, MD (Massachusetts General Hospital)	No disclosure on file
Megan Quimby (Massachusetts General Hospital)	Ms. Quimby has nothing to disclose.
Jessica Collins, PhD (Massachusetts General Hospital)	No disclosure on file
	No disclosure on file
Bradford Dickerson, MD, FAAN	Dr. Dickerson has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Dickerson has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Acadia. Dr. Dickerson has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Arkuda. Dr. Dickerson has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai. Dr. Dickerson has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lantheus. Dr. Dickerson has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lilly. Dr. Dickerson has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Dickerson has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novo Nordisk. Dr. Dickerson has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. Dickerson has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Arkuda. Dr. Dickerson has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Acadia. Dr. Dickerson has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lilly. Dr. Dickerson has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier. Dr. Dickerson has received publishing royalties from a publication relating to health care. Dr. Dickerson has received publishing royalties from a publication relating to health care.

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