TY - JOUR
T1 - Incidental Lewy body disease
T2 - Do some cases represent a preclinical stage of dementia with Lewy bodies?
AU - Frigerio, Roberta
AU - Fujishiro, Hiroshige
AU - Ahn, Tae Beom
AU - Josephs, Keith A.
AU - Maraganore, Demetrius M.
AU - DelleDonne, Anthony
AU - Parisi, Joseph E.
AU - Klos, Kevin J.
AU - Boeve, Bradley F.
AU - Dickson, Dennis W.
AU - Ahlskog, J. Eric
N1 - Funding Information:
Dr. Frigerio reports no disclosures; Dr. Fujishiro reports no disclosures; Dr. Ahn reports no disclosures; Dr. Josephs reports no disclosures; Dr. Maraganore reports a provisional application for patent under 37 CFR § 1.53 (c) entitled “Predicting Parkinson's Disease.” No monies have been awarded to date. Dr. Maraganore also reports a provisional application for patent entitled “Method of Treating Neurodegenerative Disease” that has been licensed to Alnylam Pharmaceuticals, Inc. Less than $10,000 has been awarded to date; Dr. DelleDonne reports no disclosures; Dr. Parisi reports no disclosures; Dr. Klos reports no disclosures; Dr. Boeve reports grant support from Myriad Pharmaceuticals and Honorarium from GE Healthcare; Dr. Dickson reports no disclosures; Dr. Ahlskog reports no disclosures.
Funding Information:
The authors thank Mike Oelkers and Connie McDonough for help with the Tissue Registry, and Monica Casey-Castanedes, Virginia Phillips and Linda Rousseau for histological technical support. The study was supported by the Morris K. Udall Parkinson's Disease Research Center of Excellence grant (P50 NS40256), by the NIH grant 2R01 ES10751, by the Mayo Alzheimer's Disease Research Center (P50 AG16754), by the Mayo Alzheimer's Disease Patient Registry (U01 AG06786), and by the Rochester Epidemiology Project (AR30582-43, Dr. W.A. Rocca, PI).
PY - 2011/5
Y1 - 2011/5
N2 - Lewy pathology occurs in 8-17% of neurologically normal people age >60, termed incidental Lewy body disease (iLBD). It is often assumed to represent preclinical Parkinson disease (PD). However, some iLBD cases have diffuse pathology inconsistent with preclinical PD. We analyzed iLBD cases (α-synuclein immunohistochemistry) using the Braak PD staging scheme and determined if some had a neuropathological pattern suggestive of preclinical dementia with Lewy bodies (DLB). Of the 235 brains examined, 34 had iLBD (14.5%) and all but one could be assigned a Braak PD stage. The distribution of α-synuclein pathology in the 33 cases fell into three patterns: (1) diffuse cortical and subcortical α-synuclein pathology; (2) no cortical α-synuclein pathology, but a caudal-to-rostral ascending pattern, primarily involving brainstem; and (3) intermediate between these two categories. Also, 6/33 cases failed to follow the pattern of contiguous spread proposed by Braak. These findings suggest dichotomy in the distribution of iLBD: some cases fit the Braak ascending scheme, conceptually consistent with preclinical PD, whereas others displayed prominent cortical involvement that might represent preclinical DLB.
AB - Lewy pathology occurs in 8-17% of neurologically normal people age >60, termed incidental Lewy body disease (iLBD). It is often assumed to represent preclinical Parkinson disease (PD). However, some iLBD cases have diffuse pathology inconsistent with preclinical PD. We analyzed iLBD cases (α-synuclein immunohistochemistry) using the Braak PD staging scheme and determined if some had a neuropathological pattern suggestive of preclinical dementia with Lewy bodies (DLB). Of the 235 brains examined, 34 had iLBD (14.5%) and all but one could be assigned a Braak PD stage. The distribution of α-synuclein pathology in the 33 cases fell into three patterns: (1) diffuse cortical and subcortical α-synuclein pathology; (2) no cortical α-synuclein pathology, but a caudal-to-rostral ascending pattern, primarily involving brainstem; and (3) intermediate between these two categories. Also, 6/33 cases failed to follow the pattern of contiguous spread proposed by Braak. These findings suggest dichotomy in the distribution of iLBD: some cases fit the Braak ascending scheme, conceptually consistent with preclinical PD, whereas others displayed prominent cortical involvement that might represent preclinical DLB.
KW - Dementia with Lewy bodies
KW - Incidental Lewy body disease
KW - Parkinson disease
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U2 - 10.1016/j.neurobiolaging.2009.05.019
DO - 10.1016/j.neurobiolaging.2009.05.019
M3 - Article
C2 - 19560232
AN - SCOPUS:79954602288
SN - 0197-4580
VL - 32
SP - 857
EP - 863
JO - Neurobiology of aging
JF - Neurobiology of aging
IS - 5
ER -