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Clinical and neuropathological correlates of dementia with Lewy bodies.
Ann N Y Acad Sci. 2000; 920:9-15.AN

Abstract

Dementia with Lewy bodies (DLB) is characterized pathologically by widespread Lewy body (LB) neuronal inclusions in the brain, but the contribution of LBs to the clinical syndrome of dementia and parkinsonism is unclear. In a clinical-pathological study of 25 cases with DLB, we examined the regional neuroanatomical distribution of Lewy-related pathology using alpha-synuclein immunostaining to evaluate the relationship between LBs, neuronal loss, Alzheimer-type changes, and the clinical phenotype. Compared to traditional ubiquitin immunostaining, alpha-synuclein immunohistochemistry was more specific and slightly more sensitive, staining about 5% more intracytoplasmic structures. There was a consistent pattern of vulnerability to LB formation across subcortical, paralimbic, limbic, and neocortical structures, which was independent of concomitant Alzheimer-type changes. There were no significant differences in regional LB densities among patients with or without cognitive fluctuations, visual hallucinations, delusions, recurrent falls or parkinsonism. Duration of disease correlated weakly with LB density. There was no neuronal loss in superior temporal sulcus or entorhinal cortex in pure DLB cases compared to nondemented controls. Thus, DLB is characterized by a specific neuroanatomical vulnerability to LB pathology, distinct from AD pathology, with a complicated relationship to clinical symptoms.

Authors+Show Affiliations

Alzheimer Disease Research Unit, Massachusetts General Hospital, Charlestown, Massachusetts 02129, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

11193181

Citation

Gómez-Tortosa, E, et al. "Clinical and Neuropathological Correlates of Dementia With Lewy Bodies." Annals of the New York Academy of Sciences, vol. 920, 2000, pp. 9-15.
Gómez-Tortosa E, Irizarry MC, Gómez-Isla T, et al. Clinical and neuropathological correlates of dementia with Lewy bodies. Ann N Y Acad Sci. 2000;920:9-15.
Gómez-Tortosa, E., Irizarry, M. C., Gómez-Isla, T., & Hyman, B. T. (2000). Clinical and neuropathological correlates of dementia with Lewy bodies. Annals of the New York Academy of Sciences, 920, 9-15.
Gómez-Tortosa E, et al. Clinical and Neuropathological Correlates of Dementia With Lewy Bodies. Ann N Y Acad Sci. 2000;920:9-15. PubMed PMID: 11193181.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical and neuropathological correlates of dementia with Lewy bodies. AU - Gómez-Tortosa,E, AU - Irizarry,M C, AU - Gómez-Isla,T, AU - Hyman,B T, PY - 2001/2/24/pubmed PY - 2001/3/3/medline PY - 2001/2/24/entrez SP - 9 EP - 15 JF - Annals of the New York Academy of Sciences JO - Ann N Y Acad Sci VL - 920 N2 - Dementia with Lewy bodies (DLB) is characterized pathologically by widespread Lewy body (LB) neuronal inclusions in the brain, but the contribution of LBs to the clinical syndrome of dementia and parkinsonism is unclear. In a clinical-pathological study of 25 cases with DLB, we examined the regional neuroanatomical distribution of Lewy-related pathology using alpha-synuclein immunostaining to evaluate the relationship between LBs, neuronal loss, Alzheimer-type changes, and the clinical phenotype. Compared to traditional ubiquitin immunostaining, alpha-synuclein immunohistochemistry was more specific and slightly more sensitive, staining about 5% more intracytoplasmic structures. There was a consistent pattern of vulnerability to LB formation across subcortical, paralimbic, limbic, and neocortical structures, which was independent of concomitant Alzheimer-type changes. There were no significant differences in regional LB densities among patients with or without cognitive fluctuations, visual hallucinations, delusions, recurrent falls or parkinsonism. Duration of disease correlated weakly with LB density. There was no neuronal loss in superior temporal sulcus or entorhinal cortex in pure DLB cases compared to nondemented controls. Thus, DLB is characterized by a specific neuroanatomical vulnerability to LB pathology, distinct from AD pathology, with a complicated relationship to clinical symptoms. SN - 0077-8923 UR - https://www.unboundmedicine.com/medline/citation/11193181/Clinical_and_neuropathological_correlates_of_dementia_with_Lewy_bodies_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0077-8923&date=2000&volume=920&spage=9 DB - PRIME DP - Unbound Medicine ER -