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The Lewy-Body Variant of Alzheimer's Disease

Clinical and Pathological Findings

Published online by Cambridge University Press:  02 January 2018

Hans Förstl ,
Alistair Burns ,
Phil Luthert ,
Nigel Cairns  and
Raymond Levy
Hans Förstl*
Affiliation:
Section of Old Age Psychiatry, Institute of Psychiatry, London SE5 8AF
Alistair Burns
Affiliation:
Section of Old Age Psychiatry, Institute of Psychiatry, London SE5 8AF
Phil Luthert
Affiliation:
Section of Old Age Psychiatry, Institute of Psychiatry, London SE5 8AF
Nigel Cairns
Affiliation:
Section of Old Age Psychiatry, Institute of Psychiatry, London SE5 8AF
Raymond Levy
Affiliation:
Department of Neuropathology, Institute of Psychiatry
*
∗Central Institute of Mental Health, PO Box 122120, JS, W6800 Mannheim, Germany
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Abstract

At post-mortem, Lewy bodies (LBs) were found in the brainstem and neocortex of eight out of 65 patients who had been collected during a prospective long-term study on clinically diagnosed Alzheimer’s disease. All eight patients had accompanying Alzheimer pathology which was less severe than in a sample of eight age and sex-matched patients from the same study with neuropathologically verified Alzheimer's disease. Parkinsonian features were more common in patients with LBs. There were no particular differences in duration of illness, severity of cognitive impairment, presence of hallucinations, or fluctuations in the course of illness. Frontal cerebral atrophy was more marked in patients with LBs, as was the loss of neurons in the basal nucleus of Meynert and the substantia nigra. Cognitive performance correlated with the number of pigmented neurons in the substantia nigra. We conclude that the differential diagnosis of LB dementia should be considered in patients satisfying NINCDS-ADRDA criteria for Alzheimer-type dementia who show marked Parkinsonian features and a frontal accentuation of cerebral atrophy.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 162 , Issue 3 , March 1993 , pp. 385 - 392
Copyright
Copyright © The Royal College of Psychiatrists 

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