[An autopsy case of senile dementia with pathological features of Parkinson's disease]

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Published on: January 5, 2016

Kenichi Oshima1, Kuniaki Tsuchiya, Shuji Iritani

  • 1Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, 2-1-1 Kamikitazawa, Setagaya-ku, Tokyo 156-0057, Japan.

No to Shinkei = Brain and Nerve
|September 24, 2004
PubMed

Insights

This autopsy case reveals Parkinson's disease presenting with dementia-like symptoms, highlighting Lewy body pathology in the brainstem. The findings suggest Parkinson's disease may manifest with broader clinical features than previously understood.

Area of Science:

  • Neuropathology
  • Neurodegenerative Diseases

Background:

  • Parkinson's disease (PD) is a neurodegenerative disorder primarily affecting motor function.
  • Dementia with Lewy bodies (DLB) shares overlapping pathology with PD, including Lewy bodies.
  • Distinguishing PD with dementia from Alzheimer's disease can be challenging clinically.

Observation:

  • An autopsy case of a 74-year-old man who exhibited memory disturbance and visual hallucinations at age 70.
  • Macroscopic examination revealed depigmentation of the substantia nigra and locus ceruleus.
  • Histological analysis confirmed neuronal loss, astrocytosis, and Lewy bodies in multiple brain regions, including the nucleus basalis of Meynert, substantia nigra, locus ceruleus, and dorsal vagal nucleus.

Findings:

  • The case presented with widespread senile plaques (Braak stage C) and some neurofibrillary changes (Braak stage III).
  • Pathological diagnosis aligned with brainstem-dominant Lewy body disease, consistent with Parkinson's disease.
  • The patient lacked overt neurological signs during his clinical course, mimicking Alzheimer's disease.

Implications:

  • This case underscores that Parkinson's disease can present with cognitive and psychiatric symptoms, mimicking other dementia types.
  • The findings suggest a broader spectrum of clinical manifestations for Parkinson's disease.
  • Understanding this overlap is crucial for accurate diagnosis and management of neurodegenerative disorders.

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