Pathologic Correlates of Dementia in Individuals with Lewy Body Disease
Article first published online: 12 APR 2010
© 2010 The Authors; Journal Compilation © 2010 International Society of Neuropathology
Volume 20, Issue 3, pages 654–659, May 2010
How to Cite
Sonnen, J. A., Postupna, N., Larson, E. B., Crane, P. K., Rose, S. E., Montine, K. S., Leverenz, J. B. and Montine, T. J. (2010), Pathologic Correlates of Dementia in Individuals with Lewy Body Disease. Brain Pathology, 20: 654–659. doi: 10.1111/j.1750-3639.2009.00371.x
- Issue published online: 12 APR 2010
- Article first published online: 12 APR 2010
- Received 3 December 2009; accepted 7 December 2009.
- Lewy body disease;
Cognitive impairment and dementia are more common in patients with Parkinson disease (PD) than age-matched controls and appear to become more frequent as PD progresses. However, estimates of dementia in patients with PD have varied widely, likely due in part to differences in case definition, case ascertainment and methodology. First, we review investigations of usual pathologic correlates of dementia in patients with brainstem (b) Lewy Body Disease (LBD) and report our findings from the initial 266 brain autopsies from a population-based study of brain aging and incident dementia. Our results showed that 2.6% of subjects were diagnosed with PD during life but that 20% had bLBD at autopsy. Seventy percent of individuals with bLBD had high level of one or more cerebral pathologic changes significantly associated with dementia: Alzheimer's disease (AD), cerebral (c) LBD or microvascular brain injury (µVBI); these were commonly co-morbid. Next we consider proposed contributors to cognitive impairment and dementia in the approximately 30% of patients with only bLBD, including regionally selective dendritic degeneration of neostriatal medium spiny neurons. Diseases contributing to cognitive impairment and dementia in patients with bLBD are heterogeneous, providing diagnostic challenges as well as multiple opportunities for successful intervention in patients with PD.