Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-03T08:31:39.513Z Has data issue: false hasContentIssue false
  • English
  • Français

Clinical, neuropathological and neuroimaging features of Alzheimer's disease and dementia with Lewy bodies

Published online by Cambridge University Press:  16 September 2011

Rebecca J Hancock
Rebecca J Hancock*
Affiliation:
The Royal Bournemouth Hospital, Bournemouth, UK
Get access Rights & Permissions [Opens in a new window]

Summary

Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) are the two most common types of degenerative dementia. It has been questioned whether they are totally separate conditions, or whether they are in fact both part of a spectrum of a more general neurodegenerative disease. Fluctuating cognition and parkinsonism are key features of DLB, but atypical in AD which is characterized by progressive amnesia, aphasia, agnosia and apraxia. Neuropsychiatric disturbances also seem to be more common in DLB. The main neuropathological features of DLB are Lewy bodies, and in AD are senile plaques and neurofibrillary tangles, though some overlap has been found. A key finding of neuroimaging studies is that there is relative preservation of brain volume in DLB patients compared with AD patients, particularly of temporal lobe structures. There are also profound reductions in striatal dopamine transport in DLB, demonstrated by single photon emission computerized tomography (SPECT) imaging. Whilst there are some distinct differences between AD and DLB, further research is needed to greater define the distinctions between these two conditions.

Keywords

dementiaAlzheimer's diseasedementia with Lewy bodiesneurodegenerative disease
Type
Biological gerontology
Information
Reviews in Clinical Gerontology , Volume 22 , Issue 1 , February 2012 , pp. 1 - 9
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Burns, A, Iliffe, S. Dementia. BMJ 2009; 338: 405–9.CrossRefGoogle ScholarPubMed
2Andreasen, NC. Dementias. In Brave New Brain, 1st edn, pp. 253–77. USA, Oxford University Press, 2001.CrossRefGoogle Scholar
3Lovestone, S. Dementia: Alzheimer's disease. In New Oxford Textbook of Psychiatry Volume 1, 1st edn, ed. Gelder, MG, Lopez-Ibor, JJ Jr, Andreason, N, pp. 387–97. UK, Oxford University Press, 2003.Google Scholar
4Riter, RN, Fries, BE. Predictors of the placement of cognitively impaired residents on special care units. Gerontologist 1992; 32: 184–90.CrossRefGoogle ScholarPubMed
5McKeith, IG. Lewy body dementia. In New Oxford Textbook of Psychiatry Volume 1, 1st edn, ed. Gelder, MG, Lopez-Ibor, JJ Jr, Andreason, N, pp. 415–21. UK, Oxford University Press, 2003.Google Scholar
6Burn, DJ, Perry, EK, O'Brien, JT et al. Dementia with Lewy bodies. In Neurobiology of Mental Illness, 2nd edn, ed. Charney, DS, Nestler, EJ, pp. 881–95. USA, Oxford University Press, 2006.Google Scholar
7Levy, JA, Chelune, GJ. Cognitive-behavioral profiles of neurodegenerative dementias: beyond Alzheimer's disease. J Geriatr Psychiat Neurol 2007; 20: 227–38.CrossRefGoogle ScholarPubMed
8Ballard, C, O'Brien, J, Gray, A, Cormack, F, Ayre, G, Rowan, E, Thompson, P, Bucks, R, McKeith, I, Walker, M, Tovee, M. Attention and fluctuating attention in patients with dementia with Lewy bodies and Alzheimer disease. Arch Neurol 2001; 58: 977–82.CrossRefGoogle ScholarPubMed
9Perry, RJ, Watson, P, Hodges, JR. The nature and staging of attentional dysfunction in early (minimal and mild) Alzheimer's disease: relationship to episodic and semantic memory impairment. Neuropsychologia 2000; 38: 252–71.CrossRefGoogle ScholarPubMed
10Hodges, JR, Patterson, K. Is semantic memory consistently impaired early in the course of Alzheimer's disease? Neuroanatomical and diagnostic implications. Neuropsychologia 1995; 33: 441–59.CrossRefGoogle ScholarPubMed
11Metzler-Baddeley, C. A review of cognitive impairments in dementia with Lewy bodies relative to Alzheimer's disease and Parkinson's disease with dementia. Cortex 2007; 43: 583–600.Google Scholar
12Collerton, D, Burn, D, McKeith, I, O'Brien, J. Systematic review and meta-analysis show that dementia with Lewy bodies is a visual-perceptual and attentional-executive dementia. Dementia Geriatr Cognit Disorders 2003; 16: 229–37.Google Scholar
13Hansen, L, Salmon, D, Galasko, D et al. The Lewy body variant of Alzheimer's disease: a clinical and pathological entity. Neurology 1990; 40: 1–8.CrossRefGoogle Scholar
14Crowell, TA, Luis, CA, Cox, DE, Mullan, M. Neuropsychological comparison of Alzheimer's disease and dementia with Lewy bodies. Dementia Geriatr Cognit Disorders 2007; 23: 120–25.CrossRefGoogle ScholarPubMed
15Guidi, M, Paciaroni, L, Paolini, S, De Padova, S, Scarpino, O. Differences and similarities in the neuropsychological profile of dementia with Lewy bodies and Alzheimer's disease in the early stage. J Neurol Sci 2006; 248: 120–23.CrossRefGoogle ScholarPubMed
16Noe, E, Marder, K, Bell, KL, Jacobs, DM, Manly, JJ, Stern, Y. Comparison of dementia with Lewy bodies to Alzheimer's disease and Parkinson's disease with dementia. Movement Disorders 2004; 19: 60–67.CrossRefGoogle ScholarPubMed
17Kraybill, ML, Larson, EB, Tsuang, DW, Teri, L, McCormick, WC, Bowen, JD, Kukull, WA, Leverenz, JB, Cherrier, MM. Cognitive differences in dementia patients with autopsy-verified AD, Lewy body pathology, or both. Neurology 2005; 64: 2069–73.Google Scholar
18Walker, MP, Ayre, GA, Cummings, JL, Wesnes, K, McKeith, IG, O'Brien, JT, Ballard, CG. Quantifying fluctuation in dementia with Lewy bodies, Alzheimer's disease, and vascular dementia. Neurology 2000; 54: 1616–25.CrossRefGoogle ScholarPubMed
19Calderon, J, Perry, RJ, Erzinclioglu, SW, Berrios, GE, Dening, TR, Hodges, JR. Perception, attention and working memory are disproportionately impaired in dementia with Lewy bodies compared with Alzheimer's disease. J Neurol Neurosurg Psychiat 2001; 70: 157–64.Google Scholar
20Bradshaw, JM, Saling, M, Anderson, V, Hopwood, M, Brodtmann, A. Higher cortical deficits influence attentional processing in dementia with Lewy bodies, relative to patients with dementia of the Alzheimer's type and controls. J Neurol Neurosurg Psychiat 2006; 77: 1129–35.CrossRefGoogle ScholarPubMed
21Cormack, F, Aarsland, D, Ballard, C, Tovee, MJ. Pentagon drawing and neuropsychological performance in dementia with Lewy bodies, Alzheimer's disease, Parkinson's disease and Parkinson's disease with dementia. Int J Geriatr Psychiat 2004; 19: 371–77.CrossRefGoogle ScholarPubMed
22Ala, TA, Hughes, LF, Kyrouac, GA, Ghobrial, MW, Elble, RJ. Pentagon copying is more impaired in dementia with Lewy bodies than in Alzheimer's disease. J Neurol Neurosurg Psychiat 2001; 70: 483–88.Google Scholar
23Gnanalingham, KK, Byrne, EJ, Thornton, A, Sambrook, MA, Bannister, P. Motor and cognitive function in Lewy body dementia: comparison with Alzheimer's and Parkinson's diseases. J Neurol Neurosurg Psychiat 1997; 62: 243–52.Google Scholar
24Stavitsky, K, Brickman, AM, Scarmeas, N, Torgan, RL, Tang, MX, Albert, M, Brandt, J, Blacker, D, Stern, Y. The progression of cognition, psychiatric symptoms, and functional abilities in dementia with Lewy bodies and Alzheimer disease. Arch Neurol 2006; 63: 1450–56.Google Scholar
25Ballard, CG, O'Brien, JT, Swann, AG, Thompson, P, Neill, D, McKeith, IG. The natural history of psychosis and depression in dementia with Lewy bodies and Alzheimer's disease: persistence and new cases over 1 year of follow-up. J Clin Psychiat 2001; 62: 46–49.CrossRefGoogle ScholarPubMed
26Ballard, C, Holmes, C, McKeith, I, Neill, D, O'Brien, J, Cairns, N, Lantos, P, Perry, E, Ince, P, Perry, R. Psychiatric morbidity in dementia with Lewy bodies: a prospective clinical and neuropathological comparative study with Alzheimer's disease. Am J Psychiat 1999; 156: 1039–45.Google Scholar
27Hirono, N, Mori, E, Imamura, T, Shimomura, T, Hashimoto, M. Neuropsychiatric features in dementia with Lewy bodies and Alzheimer's disease. No To Shinkei/Brain Nerve 1998; 50: 45–49.Google ScholarPubMed
28Engelborghs, S, Maertens, K, Nagels, G, Vloeberghs, E, Mariën, P, Symons, A, Ketels, V, Estercam, S, Somers, N, De Deyn, PP. Neuropsychiatric symptoms of dementia: cross-sectional analysis from a prospective, longitudinal Belgian study. Int J Geriatr Psychiat 2005; 20: 1028–37.Google Scholar
29Lennox, GG. Lewy body dementia. Ballieres Clin Neurol 1992; 1: 653–76.Google Scholar
30Aarsland, D, Ballard, C, McKeith, I, Perry, RH, Larsen, JP. Comparison of extrapyramidal signs in dementia with Lewy bodies and Parkinson's disease. J Neuropsychiat Clin Neurosci 2001; 13: 374–79.CrossRefGoogle ScholarPubMed
31Ballard, CG, O'Brien, J, Swann, A et al. One year follow-up of Parkinsonism in dementia with Lewy bodies. Dementia Geriatr Cognit Disorders 2000; 11: 219–22.Google Scholar
32Allan, LM, Ballard, CG, Burn, DJ, Kenny, RA. Prevalence and severity of gait disorders in Alzheimer's and non-Alzheimer's dementias. J Am Geriatr Soc 2005; 53: 1681–87.Google Scholar
33Ballard, CG, Shaw, F, Lowery, K, McKeith, I, Kenny, R. The prevalence, assessment and associations of falls in dementia with Lewy bodies and Alzheimer's disease. Dementia Geriatr Cognit Disorders 1999; 10: 97–103.CrossRefGoogle ScholarPubMed
34Murman, DL, Kuo, SB, Powell, MC, Colenda, CC. The impact of parkinsonism on costs of care in patients with AD and dementia with Lewy bodies. Neurology 2003; 61: 944–49.CrossRefGoogle ScholarPubMed
35Bostrom, F, Jonsson, L, Minthon, L, Londos, E. Patients with Lewy body dementia use more resources than those with Alzheimer's disease. Int J Geriatr Psychiat 2007; 22: 713–19.Google Scholar
36Spillantini, MG, Schmidt, ML, Lee, VM, Trojanowski, JQ, Jakes, R, Goedert, M. Alpha-synuclein in Lewy bodies. Nature 1997; 388: 839–40.Google Scholar
37Perry, RH, Jaros, E, Ince, PI et al. Dementia with Lewy bodies: histological aspects of differential diagnosis. Neurobiol Ageing 1998; 19: S203.Google Scholar
38McKeith, IG, Galasko, D, Kosaka, K, Perry, EK, Dickson, DW, Hansen, LA, Salmon, DP, Lowe, J, Mirra, SS, Byrne, EJ, Lennox, G, Quinn, NP, Edwardson, JA, Ince, PG, Bergeron, C, Burns, A, Miller, BL, Lovestone, S, Collerton, D, Jansen, EN, Ballard, C, de Vos, RA, Wilcock, GK, Jellinger, KA, Perry, RH. Consensus guidelines for the clinical and pathological diagnosis of dementia with Lewy bodies (DLB): report of the consortium on DLB in international workshop. Neurology 1996; 47: 1113–24.CrossRefGoogle Scholar
39Gearing, M, Mirra, SS, Hedreen, JC, Sumi, SM, Hansen, LA, Heyman, A. The Consortium to establish a registry for Alzheimer's Disease (CERAD). Part X. Neuropathology confirmation of the clinical diagnosis of Alzheimer's disease. Neurology 1995; 45: 461–66.CrossRefGoogle Scholar
40Lovestone, S, Reynolds, CH. The phosphorylation of tau: a critical stage in neurodevelopmental and neurodegenerative processes Neuroscience 1997; 78: 309–24.Google Scholar
41Lovestone, S, Hartley, CL, Pearce, J, Anderton, BH. Phosphorylation of tau by glycogen synthase kinase-3β in intact mammalian cells: the effects on organisation and stability of microtubules. Neuroscience 1996; 73: 1145–57.CrossRefGoogle Scholar
42Hansen, LA, Samuel, W. Criteria for Alzheimer's disease and the nosology of dementia with Lewy bodies. Neurology 1997; 48: 126–32.CrossRefGoogle ScholarPubMed
43Lewis, KA, Su, Y, Jou, O, Ritchie, C, Foong, C, Hynan, LS, White, CL 3rd, Thomas, PJ, Hatanpaa, KJ. Abnormal neurites containing C-terminally truncated alpha-synuclein are present in Alzheimer's disease without conventional Lewy body pathology. Am J Pathol 2010; 177: 3037–50.Google Scholar
44Harrington, CR, Perry, RH, Perry, EK, Hurt, J, McKeith, IG, Roth, M, Wischik, CM. Senile dementia of Lewy body type and Alzheimer type are biochemically distinct in terms of paired helical filaments and hyperphosphorylated tau protein. Dementia 1994; 5: 215–28.Google ScholarPubMed
45Katzman, R, Galasko, D, Saitoh, T, Thal, LJ, Hansen, L. Genetic evidence that the Lewy body variant is indeed a phenotypic variant of Alzheimer's disease. Brain Cognition 1995; 28: 259–65.CrossRefGoogle ScholarPubMed
46Hansen, LA, Masliah, E, Galasko, D, Terry, RD. Plaque-only Alzheimer disease is usually the Lewy body variant, and vice versa. J Neuropathol Exp Neurol 1993; 52: 648–54.Google Scholar
47Heyman, A, Fillenbaum, GG, Gearing, M, Mirra, SS, Welsh-Bohmer, KA, Peterson, B, Pieper, C. Comparison of Lewy body variant of Alzheimer's disease with pure Alzheimer's disease: Consortium to Establish a Registry for Alzheimer's Disease, Part XIX. Neurology 1999; 52: 1839–44.CrossRefGoogle ScholarPubMed
48Samuel, W, Galasko, D, Masliah, E, Hanson, LA. Neocortical Lewy body counts correlate with dementia in the Lewy body variant of Alzheimer's disease. J Neuropathol Exp Neurol 1996; 55: 44–52.CrossRefGoogle ScholarPubMed
49Perry, RH, Irving, D, Blessed, G, Fairbairn, A, Perry, EK. Senile dementia of the Lewy body type: a clinically and neuropathologically distinct form of Lewy body disease. J Neurol Sci 1990; 95: 119–39.Google Scholar
50Barber, R, Ballard, C, McKeith, IG, Gholkar, A, O'Brien, JT. MRI volumetric study of dementia with Lewy bodies: a comparison with AD and vascular dementia. Neurology 2000; 54: 1304–9.Google Scholar
51Harvey, GT, Hughes, J, McKeith, IG, Briel, R, Ballard, C, Gholkar, A, Scheltens, P, Perry, RH, Ince, P, O'Brien, JT. Magnetic resonance imaging differences between dementia with Lewy bodies and Alzheimer's disease: a pilot study. Psychol Med 1999; 29: 181–87.CrossRefGoogle ScholarPubMed
52Burton, EJ, Barber, R, Mukaetova-Ladinska, EB, Robson, J, Perry, RH, Jaros, E, Kalaria, RN, O'Brien, JT. Medial temporal lobe atrophy on MRI differentiates Alzheimer's disease from dementia with Lewy bodies and vascular cognitive impairment: a prospective study with pathological verification of diagnosis. Brain: J Neurol 2009; 132: 195–203.CrossRefGoogle ScholarPubMed
53Whitwell, JL, Weigand, SD, Shiung, MM, Boeve, BF, Ferman, TJ, Smith, GE, Knopman, DS, Petersen, RC, Benarroch, EE, Josephs, KA, Jack, CR Jr. Focal atrophy in dementia with Lewy bodies on MRI: a distinct pattern from Alzheimer's disease. Brain: J Neurol 2007; 130: 708–19.CrossRefGoogle ScholarPubMed
54Barber, R, Gholkar, A, Scheltens, P, Ballard, C, McKeith, IG, O'Brien, JT. Medial temporal lobe atrophy on MRI in dementia with Lewy bodies. Brain: J Neurol 1999; 52: 1153–58.Google ScholarPubMed
55Hashimoto, M, Kitagaki, H, Imamura, T, Hirono, N, Shimomura, T, Kazui, H, Tanimukai, S, Hanihara, T, Mori, E. Medial temporal and whole-brain atrophy in dementia with Lewy bodies. Neurology 1998; 51: 357–62.Google Scholar
56Barber, R, McKeith, IG, Ballard, C, Gholkar, A, O'Brien, JT. A comparison of medial and lateral temporal lobe atrophy in dementia with Lewy bodies and Alzheimer's disease: magnetic resonance imaging volumetric study. Dementia Geriatr Cognit Disorders 2001; 12: 198–205.CrossRefGoogle ScholarPubMed
57Piggott, MA, Marshall, EF, Thomas, N, Lloyd, S, Court, JA, Jaros, E, Burn, D, Johnson, M, Perry, RH, McKeith, IG, Ballard, C, Perry, EK. Striatal dopaminergic markers in dementia with Lewy bodies, Alzheimer's and Parkinson's diseases: rostrocaudal distribution. Brain 1999; 122: 1449–68.Google Scholar
58Walker, RWH, Walker, Z. Dopamine transporter single photon emission computerized tomography in the diagnosis of dementia with Lewy bodies. Movement Disorders 2009; 24: 754–59.Google Scholar
59Booij, J, Habraken, JB, Bergmans, P, Tissingh, G, Winogrodzka, A, Wolters, EC, Janssen, AG, Stoof, JC, van Royen, EA. Imaging of dopamine transporters with iodine-123-FP-CIT SPECT in healthy controls and patients with Parkinson's disease. J Nuclear Med 1998; 39: 1879–84.Google Scholar
60McKeith, I, O'Brien, J, Walker, Z, Tatsch, K, Booij, J, Darcourt, J, Padovani, A, Giubbini, R, Bonuccelli, U, Volterrani, D, Holmes, C, Kemp, P, Tabet, N, Meyer, I, Reininger, C; DLB Study Group. Sensitivity and specificity of dopamine transporter imaging with 123I-FP-CIT SPECT in dementia with Lewy bodies: a phase III, multicentre study. Lancet Neurol 2007; 6: 305–13.CrossRefGoogle ScholarPubMed
61O'Brien, JT, Colloby, S, Fenwick, J, Williams, ED, Firbank, M, Burn, D, Aarsland, D, McKeith, IG. Dopamine transporter loss visualized with FP-CIT SPECT in the differential diagnosis of dementia with Lewy bodies. Arch Neurol 2004; 61: 919–25.CrossRefGoogle ScholarPubMed
62Walker, Z, Costa, DC, Walker, RW, Shaw, K, Gacinovic, S, Stevens, T, Livingston, G, Ince, P, McKeith, IG, Katona, CL. Differentiation of dementia with Lewy bodies from Alzheimer's disease using a dopaminergic presynaptic ligand. J Neurol Neurosurg Psychiat 2002; 73: 134–40.CrossRefGoogle ScholarPubMed
63O'Brien, JT, McKeith, IG, Walker, Z, Tatsch, K, Booij, J, Darcourt, J, Marquardt, M, Reininger, C; DLB Study Group. Diagnostic accuracy of 123I-FP-CIT SPECT in possible dementia with Lewy bodies. Br J Psychiat 2009; 194: 34–39.CrossRefGoogle ScholarPubMed