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The progression of pathology in longitudinally followed patients with Parkinson's disease.
Acta Neuropathol. 2008 Apr; 115(4):409-15.AN

Abstract

The present study describes the pathological progression of longitudinally followed cases with levodopa-responsive Parkinson's disease who came to autopsy during the Sydney Multicenter Study of Parkinson's disease. Standardised clinical and neuropathological assessments over five epochs of time verified three different clinicopathological groups. A group of younger onset patients with a typical long duration clinical course of Parkinson's disease. This group of cases had Lewy body distributions consistent with the Braak staging of disease. In this group, brainstem Lewy bodies dominate in those surviving to 5 years; by 13 years, 50% of cases have a limbic distribution of Lewy bodies; and by 18 years, all will have at least this pathological phenotype. Approximately 25% of cases had an early malignant, dementia-dominant syndrome and severe neocortical disease consistent with dementia with Lewy bodies. The last group had an older onset, shorter survival, and a more complex disease course with higher Lewy body loads and a higher proportion with additional neuropathologies. These cases with higher loads of Lewy bodies and shorter survivals suggest that widespread Lewy body pathology either occurs at the onset of clinical disease or rapidly infiltrates the brain. In these cases with shorter survivals, there was more plaque pathology, supporting a more aggressive and linked phenotype. Our data suggest that the selection of similar study cohorts by pathology alone would not be able to differentiate the three different phenotypes identified. The data are also not consistent with a unitary concept of the pathogenesis of Lewy body disease.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Halliday G
Prince of Wales Medical Research Institute and the University of New South Wales, Barker Street, Randwick, NSW, 2031, Australia. g.halliday@powmri.edu.au
Hely M
No affiliation info available
Reid W
No affiliation info available
Morris J
No affiliation info available

MeSH

AgedAged, 80 and overDisease ProgressionFemaleHumansLongitudinal StudiesMaleParkinson DiseaseRetrospective StudiesStatistics as TopicTime Factors

Pub Type(s)

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

Language

eng

PubMed ID

18231798

Citation

Halliday, Glenda, et al. "The Progression of Pathology in Longitudinally Followed Patients With Parkinson's Disease." Acta Neuropathologica, vol. 115, no. 4, 2008, pp. 409-15.
Halliday G, Hely M, Reid W, et al. The progression of pathology in longitudinally followed patients with Parkinson's disease. Acta Neuropathol. 2008;115(4):409-15.
Halliday, G., Hely, M., Reid, W., & Morris, J. (2008). The progression of pathology in longitudinally followed patients with Parkinson's disease. Acta Neuropathologica, 115(4), 409-15. https://doi.org/10.1007/s00401-008-0344-8
Halliday G, et al. The Progression of Pathology in Longitudinally Followed Patients With Parkinson's Disease. Acta Neuropathol. 2008;115(4):409-15. PubMed PMID: 18231798.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The progression of pathology in longitudinally followed patients with Parkinson's disease. AU - Halliday,Glenda, AU - Hely,Mariese, AU - Reid,Wayne, AU - Morris,John, Y1 - 2008/01/30/ PY - 2007/12/09/received PY - 2008/01/18/accepted PY - 2008/01/17/revised PY - 2008/1/31/pubmed PY - 2008/8/2/medline PY - 2008/1/31/entrez SP - 409 EP - 15 JF - Acta neuropathologica JO - Acta Neuropathol VL - 115 IS - 4 N2 - The present study describes the pathological progression of longitudinally followed cases with levodopa-responsive Parkinson's disease who came to autopsy during the Sydney Multicenter Study of Parkinson's disease. Standardised clinical and neuropathological assessments over five epochs of time verified three different clinicopathological groups. A group of younger onset patients with a typical long duration clinical course of Parkinson's disease. This group of cases had Lewy body distributions consistent with the Braak staging of disease. In this group, brainstem Lewy bodies dominate in those surviving to 5 years; by 13 years, 50% of cases have a limbic distribution of Lewy bodies; and by 18 years, all will have at least this pathological phenotype. Approximately 25% of cases had an early malignant, dementia-dominant syndrome and severe neocortical disease consistent with dementia with Lewy bodies. The last group had an older onset, shorter survival, and a more complex disease course with higher Lewy body loads and a higher proportion with additional neuropathologies. These cases with higher loads of Lewy bodies and shorter survivals suggest that widespread Lewy body pathology either occurs at the onset of clinical disease or rapidly infiltrates the brain. In these cases with shorter survivals, there was more plaque pathology, supporting a more aggressive and linked phenotype. Our data suggest that the selection of similar study cohorts by pathology alone would not be able to differentiate the three different phenotypes identified. The data are also not consistent with a unitary concept of the pathogenesis of Lewy body disease. SN - 0001-6322 UR - https://www.unboundmedicine.com/medline/citation/18231798/The_progression_of_pathology_in_longitudinally_followed_patients_with_Parkinson's_disease_ DB - PRIME DP - Unbound Medicine ER -