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Clinicopathological Outline of Dementia with Lewy Bodies Applying the Revised Criteria: The Hisayama Study

Authors

  • Kouhei Fujimi MD,

    Corresponding author
    1. Department of Neuropathology, Neurological Institute.
    2. Department of Psychiatry.
    3. Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
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  • Kensuke Sasaki MD, PhD,

    1. Department of Neuropathology, Neurological Institute.
    2. Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
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  • Kazuhito Noda MD,

    1. Department of Neuropathology, Neurological Institute.
    2. Department of Medicine, Division of Respiratory, Neurology, and Rheumatology, Kurume University.
    3. Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
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  • Yoshinobu Wakisaka MD, PhD,

    1. Department of Neuropathology, Neurological Institute.
    2. Department of Medicine and Clinical Sciences.
    3. Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
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  • Yumihiro Tanizaki MD, PhD,

    1. Department of Medicine and Clinical Sciences.
    2. Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
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  • Yukiko Matsui MD,

    1. Department of Medicine and Clinical Sciences.
    2. Department of Psychiatry.
    3. Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
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  • Atsuko Sekita MD,

    1. Department of Medicine and Clinical Sciences.
    2. Department of Psychiatry.
    3. Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
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  • Mitsuo Iida MD, PhD,

    1. Department of Medicine and Clinical Sciences.
    2. Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
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  • Yutaka Kiyohara MD, PhD,

    1. Department of Environmental Medicine.
    2. Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
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  • Shigenobu Kanba MD, PhD,

    1. Department of Psychiatry.
    2. Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
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  • Toru Iwaki MD, PhD

    1. Department of Neuropathology, Neurological Institute.
    2. Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
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Kouhei Fujimi, MD, Department of Neuropathology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812–8582, Japan (E-mail: fujimi@np.med.kyushu-u.ac.jp)

Abstract

To explore the validity of the criteria for dementia with Lewy bodies (DLB) revised in 2005, we examined community based consecutive autopsy cases. 10.3% of the non-demented subjects and 31.2% of the demented subjects showed the Lewy body pathology. Applying the revised pathological criteria to the 205 demented subjects, the types of LB pathology of 11 cases (5.4%) were brainstem-predominant, 24 cases (11.7%) were limbic type and 24 cases (11.7%) were diffuse neocortical type, although there were many subjects not to fit the criteria exactly. The prevalence of Lewy bodies (LBs) was almost same regardless of gender; however, the extent of the LB pathology among females was more severe than that in males. The likelihood of DLB being modified by concomitant Alzheimer's pathology was as follows: 27 cases (13.2%) showed low likelihood, 16 cases (7.8%) showed intermediate likelihood and 16 cases (7.8%) showed high likelihood. Since the numbers of clinical features of DLB were significantly higher in the pathological intermediate and high likelihood DLB groups than in the low likelihood DLB group or no LB group, both the intermediate and high likelihood groups of DLB should be considered as pathological DLB.

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