Cortical Lewy bodies in Alzheimer's disease

Forty-eight cases of pathologically verified Alzheimer's disease were examined for the presence of ubiquitin-positive cortical Lewy bodies (CLBs). Thirty-four (71%) of 48 cases of Alzheimer's disease had CLBs compared with 4 (44%) of nine patients with idiopathic Parkinson's disease, and 2 (20%) of 10 patients with multi-infarct dementia. None of the 18 cognitively intact elderly controls we examined had CLBs. Among Alzheimer's disease patients, there was a strong correlation between CLBs and degenerative changes in the substantia nigra. We also found an association between the presence of CLBs and extrapyramidal symptoms. Among Alzheimer's disease patients, there was no association of CLBs with either senile plaques or neurons containing neurofibrillary tangles in hippocampus, neocortex, or ventral striatum. The incidence of CLBs among pathologically verified Alzheimer's disease cases is high when a careful search for these inclusions is performed with a sensitive method such as anti-ubiquitin immunocytochemistry.