Neurology®
The most widely read and highly cited peer-reviewed Neurology journal
Quick Search
Advanced Search
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Correspondence:
Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Correspondence are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Ballard, C.
Right arrow Articles by Aarsland, D.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Ballard, C.
Right arrow Articles by Aarsland, D.
Related Collections
Right arrow Parkinson's disease/Parkinsonism
Right arrow Dementia with Lewy bodies
Right arrowRelated Articles
NEUROLOGY 2006;67:1931-1934
© 2006 American Academy of Neurology

Differences in neuropathologic characteristics across the Lewy body dementia spectrum

C. Ballard, MRCPsych, I. Ziabreva, PhD, R. Perry, FRCPath, J. P. Larsen, MD, J. O'Brien, FRCPsych, I. McKeith, FRCPsych, E. Perry, DSc and D. Aarsland, MD

From the Wolfson Centre for Age-Related Diseases (C.B.), Wolfson Building, Guy's Campus, King's College London, UK; Institute of Ageing and Health (I.Z., R.P., J.O., I.M., E.P.), Newcastle General Hospital, Newcastle upon Tyne, UK; and Norwegian Center for Movement Disorders (J.P.L., D.A.), Stavanger University Hospital, Stavanger, Norway.

Address correspondence and reprint requests to Dr. Ballard, Wolfson Centre for Age-Related Diseases, Wolfson Building, Guy's Campus, King's College London, London, SE1 1UL, UK; e-mail: clive.ballard{at}kcl.ac.uk

Background: The objective of this comparative neuropathologic study was to determine the extent to which dementia with Lewy bodies (DLB) and Parkinson disease dementia (PDD) are distinct entities or part of a continuum with respect to the duration of parkinsonism.

Methods: We evaluated the relationship between cortical {alpha}-synuclein pathology, plaques (Consortium to Establish a Registry for Alzheimer's Disease [CERAD]), tangles (Braak staging), and cholinergic deficits (choline acetyltransferase in temporal cortex) in 57 prospectively assessed patients (29 DLB, 28 PDD), confirmed at autopsy. The PDD group was divided according to the median duration of parkinsonism prior to dementia.

Results: There was an association between longer duration of parkinsonism prior to dementia and less severe cortical {alpha}-synuclein pathology ({chi}2 10.4, df 2, p = 0.006) and lower CERAD plaque scores ({chi}2 26.6, df 9, p = 0.002), but not Braak staging. These findings were confirmed in a further correlation analysis, which also identified an unexpected correlation between more pronounced cortical cholinergic deficits and longer duration of parkinsonism prior to dementia (R = –0.37, p = 0.04).

Conclusion: While there is a clear relationship between the duration of Parkinson disease prior to the onset of dementia and key neuropathologic and neurochemical characteristics, there is a gradation of these differences across the dementia with Lewy bodies/Parkinson disease dementia spectrum and the findings do not support an arbitrary cut-off between the two disorders.

Editorial, see page 1910

Supported by the Norwegian Medical Research Council (clinical and neuropathologic assessments of the Stavanger cohort and neurochemical assessments) and the Medical Research Council UK (clinical and neuropathologic assessments of the Newcastle cohort).

Disclosure: The authors report no conflicts of interest.

Received January 26, 2006. Accepted in final form September 21, 2006.


Related Articles

December 12 Highlights
Neurology 2006 67: 1908-1909. [Full Text] [PDF]

Characterizing clinical phenotypes: The Lewys in their life or the life of their Lewys?
Carol F. Lippa and Murat Emre
Neurology 2006 67: 1910-1911. [Full Text] [PDF]



This article has been cited by other articles:


Home page
 NeurologyHome page
M. A. Burack, J. Hartlein, H. P. Flores, L. Taylor-Reinwald, J. S. Perlmutter, and N. J. Cairns
In vivo amyloid imaging in autopsy-confirmed Parkinson disease with dementia
Neurology, January 5, 2010; 74(1): 77 - 84.
[Abstract] [Full Text] [PDF]

Home page
 J. Neurol. Neurosurg. PsychiatryHome page
P Edison, C C Rowe, J O Rinne, S Ng, I Ahmed, N Kemppainen, V L Villemagne, G O'Keefe, K Nagren, K R Chaudhury, et al.
Amyloid load in Parkinson's disease dementia and Lewy body dementia measured with [11C]PIB positron emission tomography
J. Neurol. Neurosurg. Psychiatry, December 1, 2008; 79(12): 1331 - 1338.
[Abstract] [Full Text] [PDF]

Home page
 NeurologyHome page
S. R. Brenner, M. K. Beyer, and D. Aarsland
GRAY MATTER ATROPHY IN PARKINSON DISEASE WITH DEMENTIA AND DEMENTIA WITH LEWY BODIES
Neurology, June 3, 2008; 70(23): 2265 - 2265.
[Full Text] [PDF]

Home page
 PNHome page
I McKeith
Dementia with Lewy bodies and Parkinson's disease with dementia: where two worlds collide
Practical Neurology, November 1, 2007; 7(6): 374 - 382.
[Abstract] [Full Text] [PDF]

Home page
 BrainHome page
A. Lockhart, J.R. Lamb, T. Osredkar, L.I. Sue, J.N. Joyce, L. Ye, V. Libri, D. Leppert, and T.G. Beach
PIB is a non-specific imaging marker of amyloid-beta (A{beta}) peptide-related cerebral amyloidosis
Brain, October 1, 2007; 130(10): 2607 - 2615.
[Abstract] [Full Text] [PDF]

Home page
 NeurologyHome page
M. K. Beyer, J. P. Larsen, and D. Aarsland
Gray matter atrophy in Parkinson disease with dementia and dementia with Lewy bodies
Neurology, August 21, 2007; 69(8): 747 - 754.
[Abstract] [Full Text] [PDF]

Home page
 NeurologyHome page
C. F. Lippa and M. Emre
Characterizing clinical phenotypes: The Lewys in their life or the life of their Lewys?
Neurology, December 12, 2006; 67(11): 1910 - 1911.
[Full Text] [PDF]