@article{4cdb94b66f45435d8ef03b782b16b15c,
title = "Neocortical Lewy Body Pathology Parallels Parkinson's Dementia, but Not Always",
abstract = "Objective: The objective of this study was to evaluate the relationship between Parkinson's disease (PD) with dementia and cortical proteinopathies in a large population of pathologically confirmed patients with PD. Methods: We reviewed clinical data from all patients with autopsy data seen in the Movement Disorders Center at Washington University, St. Louis, between 1996 and 2019. All patients with a diagnosis of PD based on neuropathology were included. We used logistic regression and multivariate analysis of covariance (MANCOVA) to investigate the relationship between neuropathology and dementia. Results: A total of 165 patients with PD met inclusion criteria. Among these, 128 had clinical dementia. Those with dementia had greater mean ages of motor onset and death but equivalent mean disease duration. The delay between motor symptom onset and dementia was 1 year or less in 14 individuals, meeting research diagnostic criteria for possible or probable dementia with Lewy bodies (DLB). Braak Lewy body stage was associated with diagnosis of dementia, whereas severities of Alzheimer's disease neuropathologic change (ADNC) and small vessel pathology did not. Pathology of individuals diagnosed with DLB did not differ significantly from that of other patients with PD with dementia. Six percent of individuals with PD and dementia did not have neocortical Lewy bodies; and 68% of the individuals with PD but without dementia did have neocortical Lewy bodies. Interpretation: Neocortical Lewy bodies almost always accompany dementia in PD; however, they also appear in most PD patients without dementia. In some cases, dementia may occur in patients with PD without neocortical Lewy bodies, ADNC, or small vessel disease. Thus, other factors not directly related to these classic neuropathologic features may contribute to PD dementia. ANN NEUROL 2023;93:184–195.",
author = "Martin, {W. R.Wayne} and John Younce and Meghan Campbell and Brad Racette and Scott Norris and Mwiza Ushe and Susan Criswell and Gus Davis and Isabel Alfradique-Dunham and Baijayanta Maiti and Cairns, {Nigel J.} and Perrin, {Richard J.} and Kotzbauer, {Paul T.} and Perlmutter, {Joel S.}",
note = "Funding Information: This work was supported by grants from the National Institutes of Health (NINDS, NIA; NS075321, NS097799, NS097437, U10NS077384, and NINDS K23NS125107), the American Parkinson Disease Association (APDA), the Greater St. Louis Chapter of the APDA, the Jo Oertli Fund, the Barnes Jewish Hospital Foundation (Elliot Stein Family Fund and the Parkinson Disease Research Fund), N. Grant Williams Fund, Pohlman Fund, and the Paula and Rodger Riney Fund. Dr. Pietro Mazzoni's expertise is appreciated. We thank Erin Franklin, Susan Donovan and Michael Baxter, Aime Burns‐Harring, other personnel of the Translational Human Neurodegenerative Disease Research (THuNDR) / Betty Martz Laboratory, and the Faculty of the Neuropathology Division at Washington University for their contributions to the Movement Disorder Center neuropathology resource We thank our patients and families without whom this research would not be possible. Funding Information: This work was supported by grants from the National Institutes of Health (NINDS, NIA; NS075321, NS097799, NS097437, U10NS077384, and NINDS K23NS125107), the American Parkinson Disease Association (APDA), the Greater St. Louis Chapter of the APDA, the Jo Oertli Fund, the Barnes Jewish Hospital Foundation (Elliot Stein Family Fund and the Parkinson Disease Research Fund), N. Grant Williams Fund, Pohlman Fund, and the Paula and Rodger Riney Fund. Dr. Pietro Mazzoni's expertise is appreciated. We thank Erin Franklin, Susan Donovan and Michael Baxter, Aime Burns-Harring, other personnel of the Translational Human Neurodegenerative Disease Research (THuNDR) / Betty Martz Laboratory, and the Faculty of the Neuropathology Division at Washington University for their contributions to the Movement Disorder Center neuropathology resource We thank our patients and families without whom this research would not be possible. Publisher Copyright: {\textcopyright} 2022 American Neurological Association.",
year = "2023",
month = jan,
doi = "10.1002/ana.26542",
language = "English",
volume = "93",
pages = "184--195",
journal = "Annals of Neurology",
issn = "0364-5134",
number = "1",
}