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The Lewy body variant of Alzheimer disease

  • L. A. Hansen
Part of the Journal of Neural Transmission. Supplementa book series (NEURAL SUPPL, volume 51)

Summary

The Lewy body variant of Alzheimer disease (LBV) occupies a messy middle ground between Alzheimer disease (AD) on the one hand, and pure Lewy body diseases (Parkinson’s disease or diffuse Lewy body disease), on the other. In addition to brainstem and neocortical Lewy bodies, LBV brains have enough neocortical neuritic plaques to meet diagnostic criteria for AD. However, neurofibrillary pathology in LBV is modest, since tangle densities in LBV are typically intermediate between AD and age-matched controls or pure Lewy body disease brains. Apolipoprotein E-4 is overrepresented in LBV, as it is in AD but is not in PD or diffuse Lewy body disease (DLBD). Neurologically, LBV patients often display sufficient parkinsonian signs to separate them from AD, but these findings are usually too subtle to warrant clinical diagnoses of Parkinson’s disease (PD). Neuropsychological deficits in LBV include a subcortical dementia pattern similar to DLBD, and more severe global cognitive impairment reminiscent of AD.

Keywords

Alzheimer Disease Lewy Body Lewy Body Disease Lewy Body Dementia Alzheimer Disease Brain 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Alford MF, Masliah E, Hansen LA, Terry RD (1994) A simple dot- immunobinding assay for quantification of synaptophysin-like immunoreactivity in human brain. J Histochem Cytochem 42: 283–287.PubMedCrossRefGoogle Scholar
  2. Benjamin R, Leake A, Edwardson JA, McKeith IG, Ince PG, Perry RH, Morris CM (1994) Apolipoprotein E genes in Lewy body and Parkinson’s disease. Lancet 343:1565.PubMedCrossRefGoogle Scholar
  3. Bergeron C, Pollanen M (1989) Lewy bodies in Alzheimer disease; one or two diseases? Alzheimer Dis Assoc Disord 3: 197–204.PubMedGoogle Scholar
  4. Bierer LM, Perl DP, Haroutunian V, Mohs RC, Davis KL (1990) Neurofibrillary tangles, Alzheimer’s disease, and Lewy bodies. Lancet 335 8682: 163.CrossRefGoogle Scholar
  5. Braak H, Braak E (1991) Neuropathological stageing of Alzheimer-related changes. Acta Neuropathol 82: 239–259.PubMedCrossRefGoogle Scholar
  6. Dickson DW, Davies P, Mayeux R, Crystal H, Horoupian DS, Thompson A, Goldman JE (1987) Diffuse Lewy body disease: neuropathological and biochemical studies of six patients. Acta Neuropathol 75: 8–15.PubMedCrossRefGoogle Scholar
  7. Ditter SM, Mirra SS (1987) Neuropathologic and clinical features of Parkinson’s disease in Alzheimer’s disease patients. Neurology 37: 754–60.PubMedCrossRefGoogle Scholar
  8. Galasko D, Saitoh T, Xia Y, Thal LJ, Katzman R, Hill LR, Hansen L (1994) The apoplipoprotein E allele e4 is over-represented in patients with the Lewy body variant of Alzheimer’s disease. Neurology 44: 1950–1953.PubMedCrossRefGoogle Scholar
  9. Galasko K, Katzman R, Salmon DP, Thai LJ, Hansen L (1996) Clinical and neuropathological findings in Lewy body dementias. Brain Cogn 31:166–175.PubMedCrossRefGoogle Scholar
  10. Hansen LA, Masliah E, Terry RD, Mirra SS (1989) A neuropathological subset of Alzheimer’s disease with concomitant Lewy body disease and spongiform change. Acta Neuropathol 78: 194–201.PubMedCrossRefGoogle Scholar
  11. Hansen L, Salmon D, Galasko D, Masliah E, Katzman R, DeTeresa R, Thal L, Pay M, Hofstetter R, Klauber M, Rice V, Butters N, Alford M (1990) The Lewy body variant of Alzheimer’s disease: a clinical and pathological entity. Neurology 40: 1–8.PubMedCrossRefGoogle Scholar
  12. Hansen LA, Masliah E, Quijada-Fawcett S, Rexin D (1991) Entorhinal neurofibrillary tangles in Alzheimer’s disease with Lewy bodies. Neurosci Lett 129: 269–272.PubMedCrossRefGoogle Scholar
  13. Hansen LA, Masliah E, Galasko D, Terry RD (1993) Plaque only Alzheimer disease is usually the Lewy body variant, and vice versa. J Neuropathol Exp Neurol 52: 648–654.PubMedCrossRefGoogle Scholar
  14. Hansen LA, Galasko D, Samuel W, Xia Y, Chen X, Saitoh T (1994) Apolipoprotein-E e-4 is associated with increased neurofibrillary pathology in the Lewy body variant of Alzheimer disease. Neurosci Lett 182: 63–65.PubMedCrossRefGoogle Scholar
  15. Harrington CR, Louwagie J, Rossau R, Vanmechelen E, Perry RH, Perry EK, Xuereb JH, Roth M, Wischik CM (1994) Influence of apolipoprotein E genotype on senile dementia of the Alzheimer and Lewy body types. Am J Pathol 145: 1472–1484.PubMedGoogle Scholar
  16. Ince P, Irving D, MacArthur F, Perry RH (1991) Quantitative neuropathological study of Alzheimer-type pathology in the hippocampus: comparison of senile dementia of Lewy body type, Parkinson’s disease and non-demented elderly control patients. J Neurol Sci 106: 142–52.PubMedCrossRefGoogle Scholar
  17. Joachim CL, Morris JH, Selkoe DJ (1988) Clinically diagnosed Alzheimer disease: autopsy results in 150 cases. Ann Neurol 24: 50–6.PubMedCrossRefGoogle Scholar
  18. Khachaturian ZS (1985) Diagnosis of Alzheimer’s disease. Arch Neurol 42: 1097–105.PubMedCrossRefGoogle Scholar
  19. Kosaka K (1990) Diffuse Lewy body disease in Japan. J Neurol 237: 197–204.PubMedCrossRefGoogle Scholar
  20. Langlais PJ, Thal L, Hansen LA, Galasko D, Alford M, Masliah E (1993) Neurotransmitters in basal ganglia and cortex of Alzheimer’s disease with and without Lewy bodies. Neurology 43: 1927–1934.PubMedCrossRefGoogle Scholar
  21. Menzel H, Kladetzky RG, Assman G (1983) Apolipoprotein E polymorphism and coronary artery disease. Arteriosclerosis 3: 310–315.PubMedCrossRefGoogle Scholar
  22. Mirra SS, Hart MN, Terry RD (1993) Making the diagnosis of Alzheimer’s disease. Arch Pathol Lab Med 117: 132–144.PubMedGoogle Scholar
  23. Nalbantoglu J, Gilfix BM, Bertrand P, Robitaille Y, Gauthier S, Rosenblatt DS, Poitier J (1994) Predictive value of apolipoprotein E genotyping in Alzheimer’s disease: results of an autopsy series and an analysis of several combined studies. Ann Neurol 36: 889–895.PubMedCrossRefGoogle Scholar
  24. Perry RH, Irving D, Blessed G, Fairbairn A, Perry EK (1990) Senile dementia of the Lewy body type. A clinical and neuropathologically distinct form of Lewy body dementia in the elderly. J Neurol Sci 95: 119–139.Google Scholar
  25. Pickering-Brown SM, Mann DMA, Bourke JP, Roberts DA, Bilderson D, Burns A, Byrne J, Owen F (1994) Apolipoprotein E4 and Alzheimer’s disease pathology in Lewy body disease and in other beta amyloid forming diseases. Lancet 343: 1115.CrossRefGoogle Scholar
  26. St. Clair D, Norrman J, Perry R, Yates C, Wilcock G, Brooks A (1994) Apolipoprotein E e4 allele frequency in patients with Lewy body dementia, Alzheimer’s disease and age-matched controls. Neurosci Lett 176: 45–46.PubMedCrossRefGoogle Scholar
  27. Strittmatter WJ, Saunders AM, Schmechel D, Pericak-Vance M, Enghild J, Salvesen GS, Roses AD (1993) Apolipoprotein E: high-avidity binding to β-amyloid and increased frequency of type 4 allele in late-onset familial Alzheimer disease. Proc Natl Acad Sci USA 90: 1977–1981.PubMedCrossRefGoogle Scholar
  28. Terry RD, Hansen LA, DeTeresa R, Davies P, Tobias H, Katzman R (1987) Senile dementia of the Alzheimer type without neocortical neurofibrillary tangles. J Neuropathol Exp Neurol 46: 262–268.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag/Wien 1997

Authors and Affiliations

  • L. A. Hansen
    • 1
  1. 1.Departments of Pathology and of Neurosciences, School of MedicineUniversity of California, San DiegoLa JollaUSA

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