Clinical and neuropathological correlates of Lewy body disease

Nozomi Hishikawa, Yoshio Hashizume, Mari Yoshida, Gen Sobue

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71 Citations (Scopus)

Abstract

We investigated distribution of neuronal and glial inclusions in 30 brains obtained at autopsy from patients with Lewy bodies (LBs) disease, which was clinically diagnosed as Parkinson's disease (PD), dementia with Lewy bodies (DLB), or pure autonomic failure (PAF). The cases were classified, according to the guidelines for the pathological diagnosis of DLB, into three types: the neocortical type, the limbic type, and the brain stem-predominant type. All postmortem brains had coil-like glial inclusions as well as LBs, and the distribution pattern and density of glial inclusions and LBs varied. The distribution of glial inclusions was strikingly similar to that of LBs. In the cerebral cortex in particular, the number of glial inclusions was fairly well correlated with the number of LBs, irrespective of the three pathological types. In the brain stem, distribution was similar between glial inclusions and LBs, and there was no distinct pathological difference among the three types. Glial inclusions and LBs were immunohistopathologically similar with respect to ubiquitin, α-synuclein, and Gallyas-Braak staining. The clinical features of the three types of LB disease were also similar; i.e., parkinsonism, some dementia, and/or autonomic failure. The inclusions in neurons and glial cells occurred in parallel with respect to tissue distribution and immunohistochemical features, suggesting that accumulation of neuronal and glial inclusions in the LB diseases have a common pathological feature. Our findings suggest that DLB, PD with and without dementia, and PAF share one clinicopathological entity.

Original languageEnglish
Pages (from-to)341-350
Number of pages10
JournalActa neuropathologica
Volume105
Issue number4
Publication statusPublished - Apr 1 2003
Externally publishedYes

Keywords

  • Dementia with Lewy body disease
  • Lewy body
  • Parkinson's disease
  • Pure autonomic failure
  • α-synuclein

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Clinical Neurology
  • Cellular and Molecular Neuroscience

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