Abstract：
The patient was an 85-year-old man with a one-year history of difficulty reading kana. Neuropsychological evaluation revealed kana (phonogram)-selective reading impairment and kanji (ideogram)-dominant writing impairment. MRI revealed significant cerebral atrophy in the left occipital cortex, leading to the clinical diagnosis of posterior cortical atrophy (PCA). Cerebrospinal fluid amyloid β1-42 levels were reduced, and amyloid PET showed accumulation in the posterior cingulate cortex, precuneus, and frontal lobe. In contrast, tau PET showed no accumulation in the atrophied brain areas. Episodes of REM sleep behavior disorder and decreased uptake on meta-iodobenzylguanidine (MIBG) myocardial scintigraphy suggested the involvement of Lewy body pathology. PCA with distinct laterality has been rarely reported, and this is the first case to present Kana-selective reading impairment and Kanji-dominant writing impairment with neurodegenerative background.
摘要：
患者是一名85岁的男性，有一年的阅读假名困难史。神经心理学评估显示假名（音图）-选择性阅读障碍和汉字（表意文字）-显性书写障碍。MRI显示左枕骨皮质有明显的脑萎缩,导致后皮质萎缩（PCA）的临床诊断。脑脊液淀粉样β1-42水平降低，淀粉样蛋白PET显示在后扣带皮质中积累，precuneus,和额叶.相比之下,tauPET显示在萎缩的大脑区域没有积累。REM睡眠行为障碍的发作和间碘苄基胍（MIBG）心肌闪烁显像的摄取减少提示路易体病理学的参与。具有明显侧向性的PCA很少报道，这是第一个出现假名选择性阅读障碍和汉字显性书写障碍并伴有神经退行性背景的病例。
