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New Learning and Remote Memory in Atypical Alzheimer’s Disease

This article discusses a case study of an individual with atypical Alzheimer's disease, highlighting unusual memory patterns and the implications for diagnosis, management, and treatment development. The study explores the role of posterior cortical involvement and the potential sparing of remote/semantic memory.

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New Learning and Remote Memory in Atypical Alzheimer’s Disease

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  1. New Learning and Remote Memory in Atypical Alzheimer’s Disease Thompson, Beswick, Foster, & Snowden (2003) Yvonne Rogalski EXP 4504 December 3rd, 2007

  2. Patient Background: BB • 75-yr-old, left-handed engineer with 13-yr progressive difficulty with vision and memory • Impaired vision: • Object and face recognition • Activities of daily living • navigation • Reading, writing • Impaired memory • Forgetful of recent events • Repetitive conversation

  3. Neuropsychological Assessment • Visuo-spatial • Impaired recognition/matching/drawing of pictures • Left visual neglect, localizing problems • Memory • Good autobiographical remote memory (during clinical interview) and semantic memory • Poor performance on Wechsler Memory Scale and Warrington Recognition Memory • Language: good • Frontal Executive: good • Imaging • Moderate bilateral hippocampal atrophy • Parieto-occipital

  4. Further Investigation Warranted • Profile not consistent with typical AD • Profound visuo-spatial impairment with unusually preserved language, executive function, remote memory • Suggestive of posterior cortical AD • Anterograde/retrograde dissociation???

  5. Comparison with AD and Healthy Controls • Anterograde Memory: story recall and recognition • Similar to AD –problems with encoding and delayed retrieval • Remote Memory • Superior to AD on famous names test: recognition and recall • Higher than AD on Autobiographical Memory Interview

  6. Discussion • Posterior Cortical AD • Different from typical AD • Anterograde/remote dissociation • Remote/semantic memory spared due to location of pathology? • Parieto-occipital affected • Temporal neocortex spared (storage) • Role of hippocampus in memory? • Squire and Alvarez (1995) –hippocampus mediates recent memory only

  7. Implications • Importance of recognizing heterogeneity of AD • Differential diagnosis and Management • Treatment development • Contributes to understanding of normal subtypes of memory

  8. Critique • Imaging evidence missing • No documentation/transcript of patient interview • Was language really intact? What about discourse (train of thought)?

  9. Questions?

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