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Clinicians' ability to diagnose dementia with Lewy bodies is not affected by β Normal 0 false false false EN-GB X-NONE X-NONE -amyloid load

Lookup NU author(s): Dr Pietro Tiraboschi, Professor Johannes Attems, Professor Alan Thomas, Dr Evelyn Jaros, Debbie Lett, Dr Maria Ossola, Emeritus Professor Robert Perry, Lynne Ramsay, Dr Lauren Walker, Professor Ian McKeith

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Abstract

Objective:To investigate whether an increasing load of -amyloid and/or neuritic plaques influences the phenotype, and thus the clinical diagnostic accuracy, of dementia with Lewy bodies (DLB).Methods:A series of 64 subjects with autopsy-proven DLB was studied. Last diagnosis before death was used to determine the clinical diagnostic accuracy of DLB in relation to Lewy body distribution and extent of Alzheimer -amyloid and/or neuritic pathology. DLB pathologic diagnosis was made according to consensus criteria, using -synuclein immunostaining for Lewy body identification. -Amyloid immunostaining was used for quantifying -amyloid deposits. The Consortium to Establish a Registry for Alzheimer's Disease criteria and Braak stage were applied for semiquantitative grading of neuritic plaque and neurofibrillary tangle pathology.Results:Overall clinical diagnostic accuracy for the entire DLB cohort was high (80%), reflecting the high prevalence of core clinical features (fluctuations [81%], parkinsonism [77%], visual hallucinations [70%]). Lower frequencies of core clinical features of DLB, resulting in lower accuracy of its clinical diagnosis, were associated with decreasing Lewy body distribution (p < 0.0001) and with increasing neuritic plaque pathology (p = 0.035), but not with the number of -amyloid plaque deposits.Conclusions:The likelihood of occurrence of the DLB clinical syndrome is positively related to the extent of Lewy body pathology and negatively related to the severity of Alzheimer neuritic pathology, while -amyloid load has no effect.


Publication metadata

Author(s): Tiraboschi P, Attems J, Thomas A, Brown A, Jaros E, Lett DJ, Ossola M, Perry RH, Ramsay L, Walker L, McKeith IG

Publication type: Article

Publication status: Published

Journal: Neurology

Year: 2015

Volume: 84

Issue: 5

Pages: 496-499

Print publication date: 03/02/2015

Online publication date: 31/12/2014

Acceptance date: 06/10/2014

ISSN (print): 0028-3878

ISSN (electronic): 1526-632X

Publisher: Lippincott Williams & Wilkins

URL: http://dx.doi.org/10.1212/WNL.0000000000001204

DOI: 10.1212/WNL.0000000000001204


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