Talk:Posterior cortical atrophy

note

For the next week (11/12/13-11/15/13) two Middlebury College undergraduates will be updating this page, as part of an assignment for their Intro Neuro Class. Please visit our personal talk pages if you would like to contact us: | Nan's Talk Page | Val's Talk Page — Preceding unsigned comment added by Nphilip (talk • contribs) 14:23, 12 November 2013 (UTC)

We have uploaded a new draft of various sections on this page and will still be working on this project for the next few weeks. We welcome any comments you may have! Please visit our personal talk pages if you would like to contact us: | Nan's Talk Page | Val's Talk Page — Preceding unsigned comment added by Nphilip (talk • contribs) 14:23, 12 November 2013 (UTC) — Preceding unsigned comment added by Vbraddick (talk • contribs)

Peer Review from NSCI 0100

Comment One

Hey guys, Overall, awesome job! This was not only a very informative but also very interesting article to read. You guys separated the information between sections very well and it is relatively easy to grasp at times dense material. That being said, there were some moments were I felt the neuroscience terminology was overwhelming, and that perhaps for the non-Middlebury Intro to Neuro student may have some difficulty understanding exactly the relationship between different brain areas (although, you guys did an excellent job linking brain regions to their respective wikipedia pages). The only other additional comment I can give is that you guys cited 25 sources in your footnotes and when hearing this number I would normally expect a very long article. I am not saying that you need to revise and write a very long, dreary, boring article, but this does mean that for some more complicated sections of the article you can also include an aside explaining the complicated section in easier terms. These are very nit-picky comments: this is a very good article and a job well done! Akohutnicki (talk) 06:42, 26 November 2013 (UTC)

Responses to Comment One

Thanks so much for this comment- it was very helpful! The terminology in neuroscience can definitely get confusing at times, but our hope is that the links to the other pages will work well to supplement and further break down the article. I've also worked to clarify some of the more complicated terms-- for example, I added more detail in identifying different disorders mentioned in the article, and additionally clarified where the dorsal and ventral streams are located in both the text and by adding an additional image that points to the brain regions involved. I also added a few more links to other wiki pages, such as neurodegeneration, atrophy, and depression. In terms of the sources, I understand what you're saying, but I think it appears that we have cited many sources because many of them were repetitive and stated the same basic ideas about PCA-- we wanted to show that we have consulted multiple sources that have agreed on these facts! Thanks again for your input! Vbraddick (talk) 01:09, 4 December 2013 (UTC)

Thanks so much for your comments. I worked to change around some of the wording in the Diagnosis and Treatment sections so it may be a bit easier to understand without a neuroscience background. For example one change I made was giving brief descriptions of the different forms of imaging methods other than just linking to their respective pages. I can understand your comment on our sources, however I think that we are fine having a larger amount of sources. Thanks so much for your input! Nphilip (talk)

Comment Two

Really good job on this page. I believe that if I had no prior knowledge of general neuroscience or posterior cortical atrophy that your page would do a great job providing information. It starts off general and works into more specifics, which is important. There are a few miscellaneous grammar/spelling mistakes, I won't list them all here but they can easily be found just by reading the article from top to bottom (reading it out loud also helps). There are a few points with the content that I would like to address, but they are minor. These are also completely meant to be constructive, I truly think it is a very strong page as is. It is mentioned a number of times that there is a connection between PCA and Alzheimer's, but it is also hinted at that PCA happens mostly in younger patients, while I know Alzheimer's is more common in older patients. How young are typical PCA patients and then what is it's relationship to Alzheimer's aside from the physical deterioration of the brain? Also I'm not sure I missed it, but is there any known specific cause of PCA? I know with Alzheimer's it often just comes as the patient ages, but that doesn't seem to be the case here. It is also mentioned that it is a fairly rare disease, but it could be helpful to insert a statistic if possible to get a better idea of how many people are affected by PCA. Aside from that, I think that a few more visuals would be extremely helpful, perhaps if you could compare a PCA brain to a normal brain, or give us a closer look at the general posterior region of the brain. I find pictures very helpful when it comes to learning a new topic, and while I think you guys did an amazing job with your explanation and research, it might be a nice cherry on top. Overall, very well done, and thank you for informing me on the topic. Jyangmidd (talk) 15:16, 26 November 2013 (UTC)

Responses to Comment Two

Thank you for your input! To answer your questions, in terms of how young PCA patients are, this is stated in the opening/introduction section of the page, and is referred to later in the text as well-- PCA patients are typically in their fifties to sixties. As far as we know, this neurodegeneration in different brain regions is exactly the relationship between Alzheimer's and PCA, and we do not know much more than that as of now, but I'm sure this exact topic is being explored by neuroscientists right now! We have clarified PCA as an area of current intense research in terms of these questions you've asked, as well as possible causes of PCA, which we are also unsure of (we have also clarified this uncertainty in the article-- thanks!). Also, I've added another image to provide another visual of the brain and to further explain the locations of the ventral and dorsal visual streams I discuss in the "symptoms" section. Your suggestions have been very helpful in improving our article- thanks again! Vbraddick (talk) 01:17, 4 December 2013 (UTC)

Thanks so much for your comments, I am glad to hear that you enjoyed the article. Val and I have both read through the article and tried to eliminate all of the grammar and spelling mistakes. As Val said we initially stated the early age of the patients in the introductory/overview paragraphs, but I have also restated this again in the beginning of the Diagnosis paragraph as well as adding a clear statement to confirm that there is no specific know cause of PCA at this time. I am afraid that my research did not provide any specific statistics of the exact rarity of the disease. I would conclude that that is due to the problems with confirmed and agreed on diagnosis of the disease. Momentum and interest has started to spike in recent years, for example the first international conference on PCA was held last year. I suspect that over time as research continues, hopefully a more specific statistic of how many people are effected by PCA will become available. Thank you for the suggestion of added pictures, it has been more difficult than expected to find images pertaining to PCA that we can legally use on Wikipedia. But we have worked to add more pictures that display areas of the brain. Thank you so much for your comments! Nphilip (talk)

Comment Three

I found the page both readable and informative, a rare mixture in Neuroscience literature (at least in my experience). You cite sources consistency, adding a tone of authority to your writing, and demonstrate clear mastery of neuroscience concepts, connecting physiological and mental symptoms to brain anatomy in clear prose. For example, The paragraph:

The atrophy is progressive; early symptoms include difficulty reading, blurred vision, light sensitivity, issues with depth perception, and trouble navigating through space.[7][8] Additional symptoms include Apraxia, a movement disorder, Alexia, a reading disorder, and Visual agnosia, an object recognition disorder.[9] Damage to the ventral, or “what” stream, of the visual system in the temporal lobe leads to the symptoms related to general vision and object recognition deficits, and damage to the dorsal, or “where/how” stream in the parietal lobe, leads to PCA symptoms related to impaired movements in response to visual stimuli, such as navigation and Apraxia.[9][10]

Defines all concepts, making it understandable for those unfamiliar to neuroscience but also doesn't oversimplify concepts. Sure, someone who has not taken a neuroscience course might struggle a bit with the text. But ultimately, they would have a clear, if somewhat impomplete understanding. Another thing I like is that you integrated its connection to Alzheimer's disease throughout the article. This may seem like a trivial point. However, Alzheimer's disease is a household name whereas Posterior Cortical Atrophy is not. Making the connection clear throughout helps contextualize this disorder and provide practical information for someone who suffers or knows someone who suffers from this condition and would need to know how to treat it differently. An area that reads less clearly however is:

Magnetic Resonance Imaging (MRI's) taken of a PCA patient during the early stages of the disease can show brain atrophy in the right posterior lobe and occipital gyrus. PCA imaging can contradict the common MRI images of AD patients, which shows atrophy in the medial temporal cortex.[14][17] Single-photon emission computed tomography and Positron emission tomography studies can also be used.[18] PCA patients may show a lost of grey matter in the posterior and occipital temporal cortices mainly in the right hemisphere.

You discard the technique used in the former paragraph I pulled and do not define the neuroscience concepts rendering them meaningless for most people. David Ullmann 1994 (talk) 18:21, 26 November 2013 (UTC) David Ullmann 1994

Responses to Comment Three

Thank you so much for your comments on our page- they've been very helpful in improving the page and clarifying some areas! Vbraddick (talk) 01:57, 4 December 2013 (UTC)

Thank you for your comment. I think that you brought up a great point on the clarity of my Diagnosis section. I have reworked and re-written that section so that it can be more accessible to all readers especially those with less of a neuroscience background. I have also added additional links to other wikipedia pages while also giving a brief description of some of the more technical aspects, such as the tools for neuroimaging and also grey matter. I hope that you will now find that the Diagnosis is easier to understand and overall more clear. Thank you so much for this helpful input on our article! Nphilip (talk)

Comments from a Fellow NSCI Classmate

• Overall you did a really good job on this article! The intro was very clear and concise, allowing the reader to get a general understanding formed quickly (this is surprisingly hard to do I think).
• Good job covering the different symptoms. It's helpful that you linked to so many other pages. However, it would be helpful to add in even a couple more words to explain some of the things (ie apraxia, alexia, etc). It also might be helpful to explain what/where the ventral & dorsal streams are physically in the brain a bit more clearly. Also, you mention neural death. It might be helpful to elaborate more on this. How/why does it spread? Does this always happen? You also mention that it has some symptoms similar to Alzheimer's disease, but only give one example. Adding in a few more might be helpful too.
• For the diagnosis section, the sentence with "this may be a cause of personal insight that leads to fear..." is somewhat confusing. Other than that, nice job connecting to different brain imaging methods. Can you in even a couple words just explain the differences in these methods? Also, maybe explain quickly what grey matter is.
• The treatment and connection to Alzheimer's are also well done. Adding in a couple links to some of the drugs you mentioned might be helpful. Nice job explaining the different related brain areas in both diseases. Can you clarify what working, anterograde, and episodic memory are? It also would be interesting to expand on how it's related to the other diseases and the gene mutation you mentioned.
• Overall, nicely done. Are there any pictures/videos you can add?

Joy1818 (talk) 19:44, 26 November 2013 (UTC)

Responses to this Comment (4)

Thanks for your comments-- they've definitely helped us improve our page! I've clarified some of the terms, including apraxia and alexia, to make the disorders more clear, and of course, if users want to know more, they can click on the links to the wiki pages of these topics. I've also clarified the locations of the ventral and dorsal streams both in the text and by adding another image that shows where these streams lie, providing the reader with a visual aid. To clarify neural death/neurodegeneration, I added a short phrase defining the term, and added a link to the wiki page for neurodegeneration. To address the grey matter question, i clarified it's meaning by adding "(cell bodies)" to the text and linking to the grey matter wiki page as well. In terms of clarifying the different memory types, I've decided to leave this sentence be, as these concepts are actually quite complex-- instead, the links to other wiki pages will help define these terms for readers. The main take-away point I want readers to get is that there are different types of memory affected by the different diseases. Many thanks for your contributions to our page- they were very useful! Vbraddick (talk) 02:04, 4 December 2013 (UTC)

Thank you so much for all these great suggestions! I have worked to re-write and reword a portion of my of my diagnosis section to hopefully make it more clear about the possible cause of PCA patients having anxiety or depression. I have also added brief descriptions on each imaging method and along with the links to other wikipedia pages on each of these methods. I also added a quick description of grey matter to assist the reader if they are unaware of what grey matter is or if they dont want to click through to the grey matter page. In my treatment section I have added links to other wikipedia pages for the drugs that are used for treatment so that the reader can use these links for additional information. We have worked to add another picture to the page for visual assistance. The rarity of PCA and the lack of general awareness of the disease has made if difficult to find a large amount of images of PCA brains that we can use on the wikipedia page or videos relating to PCA. But we have worked to add some images that can help clarify regions of the brain. Nphilip (talk)

Illustrations

This may seem a somewhat trivial suggestion but I think it would be helpful if the two diagrams of the brain were oriented in the same direction. For non-experts, like myself, the brain can a confusing object to make sense of. Twizzlemas (talk) 12:26, 3 July 2014 (UTC)