Clinicians' ability to diagnose dementia with Lewy bodies is not affected by β-amyloid load

Pietro Tiraboschi, Johannes Attems, Alan Thomas, Andrew Brown, Evelyn Jaros, Debbie J. Lett, Maria Ossola, Robert H. Perry, Lynne Ramsay, Lauren Walker, Ian G. McKeith

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To investigate whether an increasing load of β-amyloid and/or neuritic plaques influences the phenotype, and thus the clinical diagnostic accuracy, of dementia with Lewy bodies (DLB). Methods: A series of 64 subjects with autopsy-proven DLB was studied. Last diagnosis before death was used to determine the clinical diagnostic accuracy of DLB in relation to Lewy body distribution and extent of Alzheimer β-amyloid and/or neuritic pathology. DLB pathologic diagnosis was made according to consensus criteria, using a-synuclein immunostaining for Lewy body identification. β-Amyloid immunostaining was used for quantifying β-amyloid deposits. The Consortium to Establish a Registry for Alzheimer's Disease criteria and Braak stage were applied for semiquantitative grading of neuritic plaque and neurofibrillary tangle pathology. Results: Overall clinical diagnostic accuracy for the entire DLB cohort was high (80%), reflecting the high prevalence of core clinical features (fluctuations [81%], parkinsonism [77%], visual hallucinations [70%]). Lower frequencies of core clinical features of DLB, resulting in lower accuracy of its clinical diagnosis, were associated with decreasing Lewy body distribution (p = 0.0001) and with increasing neuritic plaque pathology (p 5 0.035), but not with the number of β-amyloid plaque deposits. Conclusions: The likelihood of occurrence of the DLB clinical syndrome is positively related to the extent of Lewy body pathology and negatively related to the severity of Alzheimer neuritic pathology, while β-amyloid load has no effect.

Original languageEnglish
Pages (from-to)496-499
Number of pages4
JournalNeurology
Volume84
Issue number5
DOIs
Publication statusPublished - 2014

ASJC Scopus subject areas

  • Clinical Neurology

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