Cognitive Rehabilitation and Transcranial Direct Current Stimulation in a Patient with Posterior Cortical Atrophy: An fMRI Study

Patient: Male, 58 Final Diagnosis: Posterior cortical atrophy Symptoms: Oculomotor apraxia • simultagnosia • visual impairment Medication: — Clinical Procedure: tDCS and cognitive rehabilitation Specialty: Neurology OBJECTIVE: Unusual or unexpected effect of treatment BACKGROUND: Posterior cortical atrophy (PCA) is a neurodegenerative syndrome that accounts for 5% of the atypical presentation of Alzheimer disease (AD). To date, only a few studies have explored the effect of non-pharmacological treatment in PCA patients and no studies have evaluated the efficacy of transcranial direct current stimulation (tDCS) in this disorder. CASE REPORT: A 58-year-old PCA patient underwent a cognitive rehabilitation treatment followed by 2 cycles of tDCS stimulation. The effects of both treatments were monitored over time with a standardized task-based fMRI protocol and with a neuropsychological assessment. Improvements in cognitive abilities, increased fMRI activation in the dorsolateral prefrontal cortex, and deactivation of the default mode network during the Stroop test performance were detected after each session treatment. CONCLUSIONS: This combined approach lead to both cognitive improvements and neurophysiological adaptive changes, however, further studies on a larger cohort are needed to confirm these preliminary results.