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Mixed Small Vessel Disease in a Patient with Dementia with Lewy Bodies

George P Paraskevas1, Vasilios C Constantinides2, Efstratios-Stylianos Pyrgelis2

  • 11st Department of Neurology, Cognitive and Movement Disorders clinic and Unit of Neurochemistry and Biological Markers, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, 10679 Athens, Greece. geoprskvs44@gmail.com.

Brain Sciences
|July 7, 2019
PubMed
Abstract

Insights

This study presents a case of dementia with Lewy bodies (DLB) with coexisting cerebral amyloid angiopathy (CAA) and non-amyloid microangiopathy, highlighting mixed vascular and neurodegenerative pathologies in dementia.

Area of Science:

  • Neurology
  • Neuroscience
  • Vascular Dementia

Background:

  • Cerebral amyloid angiopathy (CAA) involves amyloid deposition in brain vessels and can co-occur with neurodegenerative diseases like dementia with Lewy bodies (DLB).
  • This case involves a patient with a clinical DLB diagnosis and imaging/biochemical findings suggesting mixed small vessel disease, including both CAA and non-amyloid microangiopathy.

Observation:

  • A 71-year-old male met criteria for probable DLB, confirmed by a positive dopamine-transporter scan (DAT-scan).
  • Brain imaging revealed microbleeds characteristic of CAA (cortical-subcortical) and non-amyloid microangiopathy (deep nuclei).
  • Cerebrospinal fluid (CSF) analysis showed abnormal levels of amyloid-beta 42 (Aβ42).

Findings:

  • The patient exhibited a combination of DLB, CAA, and non-amyloid microangiopathy.
  • Distinct patterns of microbleeds supported the presence of both vascular pathologies.

Implications:

  • Mixed vascular and neurodegenerative disorders are common in elderly dementia patients.
  • The interplay between these pathologies can influence the clinical presentation of dementia.
Keywords:
amyloid betacerebral amyloid angiopathycerebrospinal fluid biomarkersdementia with Lewy bodiessubcortical small vessel disease

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