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What are the relations between Lewy body disease and AD?
I G McKeith1, P Ince, E B Jaros
1Department of Old Age Psychiatry, University of Newcastle upon Tyne, United Kingdom.
Journal of Neural Transmission. Supplementum
|December 16, 1998
Summary
Dementia with Lewy bodies (DLB) is a common dementia, often showing Alzheimer
Area of Science:
- Neuropathology
- Neurodegenerative Diseases
- Geriatric Medicine
Background:
- Dementia with Lewy bodies (DLB) is the second most common pathological subtype of degenerative dementia in the elderly.
- DLB cases frequently exhibit beta-amyloid plaques, complicating Alzheimer's disease (AD) diagnosis.
- Neocortical neurofibrillary tangle density in DLB is significantly lower than in AD.
Purpose of the Study:
- To clarify the neuropathological distinctions between Dementia with Lewy bodies (DLB) and Alzheimer's disease (AD).
- To investigate the molecular differences in tau and neurofilament pathology between DLB and AD.
- To support the accurate clinical differentiation of DLB and AD.
Main Methods:
- Analysis of hospital-based autopsy series.
- Comparison of beta-amyloid senile plaque and neurofibrillary tangle densities.
- Examination of ultrastructural and molecular pathology, focusing on tau and neurofilament abnormalities.
Main Results:
- DLB exhibits high beta-amyloid plaque density but minimal neocortical neurofibrillary tangles compared to AD.
- Alzheimer's disease is characterized by tau hyperphosphorylation.
- DLB shows distinct neurofilament abnormalities, including phosphorylation, ubiquitination, proteolysis, and cross-linking.
Conclusions:
- DLB and AD are distinct diseases at ultrastructural and molecular levels.
- Distinct pathological features support accurate antemortem diagnosis of DLB versus AD.
- Understanding these differences is crucial for diagnosing and managing degenerative dementias.