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

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

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

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???

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

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

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

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

Questions?