Incidental Lewy body disease: Do some cases represent a preclinical stage of dementia with Lewy bodies?

被引：118

作者：

Frigerio, Roberta ^{[1
]}

Fujishiro, Hiroshige ^{[2
]}

Ahn, Tae-Beom ^{[2
]}

Josephs, Keith A. ^{[1
]}

Maraganore, Demetrius M. ^{[1
]}

DelleDonne, Anthony ^{[2
]}

Parisi, Joseph E. ^{[3
]}

Klos, Kevin J. ^{[4
]}

Boeve, Bradley F. ^{[1
]}

Dickson, Dennis W. ^{[2
]}

Ahlskog, J. Eric ^{[1
]}

机构：

[1] Mayo Clin, Dept Neurol, Rochester, MN 55905 USA

[2] Mayo Clin, Dept Neurosci, Jacksonville, FL 32224 USA

[3] Mayo Clin, Dept Lab Med & Pathol, Rochester, MN USA

[4] Movement Disorder Clin Oklahoma, Tulsa, OK USA

来源：

NEUROBIOLOGY OF AGING | 2011年 / 32卷 / 05期

关键词：

Incidental Lewy body disease; Parkinson disease; Dementia with Lewy bodies; ALPHA-SYNUCLEIN PATHOLOGY; PARKINSONS-DISEASE; DIAGNOSTIC-CRITERIA; ALZHEIMERS-DISEASE; NEUROPATHOLOGY; BRAIN; RELEVANCE; DLB;

D O I：

10.1016/j.neurobiolaging.2009.05.019

中图分类号：

R592 [老年病学]; C [社会科学总论];

学科分类号：

030301 [社会学]; 100201 [内科学];

摘要：

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 (alpha-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 alpha-synuclein pathology in the 33 cases fell into three patterns: (1) diffuse cortical and subcortical alpha-synuclein pathology; (2) no cortical alpha-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. (C) 2009 Elsevier Inc. All rights reserved.

引用

页码：857 / 863

页数：7

共 42 条

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