‘Lewy body disease’: clinico-pathological correlations in 18 consecutive cases of Parkinsonʹs disease with and without dementia

One of the characteristic histological features of Parkinsonʹs disease (PD), with or without dementia, is the presence of Lewy bodies (LBs) in the brainstem and neocortical and limbic structures. They are often accompanied by Alzheimer type pathology (ATP). In the present retrospective study the clinical features and post-mortem findings of 18 consecutive and unselected PD patients were compared, with special reference to the frequent but not exclusive association of LBs with ATP in Lewy body disease (LBD). LBD is the term applied to a particular pattern of neuronal degeneration associated with LBs. In this study of idiopathic PD patients ATP seems to be the major determinant of the cognitive decline in most patients. Cortical Lewy Bodies (CLBs) were present in all patients reviewed, whether or not dementia was present. It was not possible to distinguish a specific pattern in the cognitive or psychopathological symptoms of dementia that would differentiate LBD from Alzheimerʹs disease (AD). Although in most cases hippocampal CA2–3 ubiquitin immunoreactive neurites were observed, here again there was no correlation with the presence of dementia.