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Lewy body pathology in normal elderly subjects.
William R Markesbery1, Gregory A Jicha, Huaichen Liu
1Alzheimer's Disease Center and the Sanders-Brown Center on Aging, University of Kentucky College of Medicine, Lexington, Kentucky 40536, USA. wmark0@email.uky.edu
Journal of Neuropathology and Experimental Neurology
|June 19, 2009
Summary
Lewy body pathology (LBP) was found in 33 of 139 cognitively normal individuals. This suggests incidental Lewy body disease may represent preclinical Parkinson disease or related dementias.
Area of Science:
- Neuropathology
- Neurodegenerative Diseases
- Geriatric Medicine
Background:
- Lewy bodies and Lewy neurites define alpha-synucleinopathies like Parkinson disease.
- These findings, termed incidental Lewy body disease, are also observed in normal aging.
- Understanding LBP prevalence in non-demented individuals is crucial for disease staging.
Purpose of the Study:
- To determine the prevalence of Lewy body pathology (LBP) in a cohort of cognitively normal elderly individuals.
- To investigate the association of LBP with demographic, cognitive, and Alzheimer disease-related pathologies.
- To explore the implications of incidental LBP for preclinical neurodegenerative disease.
Main Methods:
- Postmortem brain tissue analysis from 139 cognitively normal volunteers at the University of Kentucky Alzheimer's Disease Center.
- Longitudinal cognitive and clinical assessments were performed on all subjects.
- Neuropathologic examination focused on the presence and distribution of Lewy bodies and Lewy neurites.
Main Results:
- Lewy body pathology (LBP) was detected in 33 out of 139 (23.7%) normal subjects.
- The most frequently affected brain regions included the medulla, amygdala, pons, and midbrain.
- No significant differences in demographics, cognitive scores, Braak stage, or Alzheimer pathology were found between subjects with and without LBP.
Conclusions:
- The high prevalence of LBP in cognitively normal elderly individuals suggests it may represent preclinical or presymptomatic stages of Parkinson disease or Lewy body dementias.
- Incidental Lewy body disease does not appear to be solely related to aging or the presence of Alzheimer disease pathology.
- These findings support the hypothesis that LBP can exist subclinically before the onset of motor or cognitive symptoms.
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