Lewy bodies were originally described in isolated brainstem nuclei in persons with Parkinson's disease. They have since been recognized as a widespread and common neuropathologic finding in individuals with dementia. Dementia with Lewy bodies (DLB) is the preferred term for the dementia syndrome associated with Lewy bodies. Although DLB is acknowledged as the second most common degenerative dementia, trailing only Alzheimer's disease, its ranking with respect to vascular dementia remains controversial. Large, community-based studies of DLB with postmortem confirmation are lacking. Available data suggest that DLB is more common than pure vascular dementia but not more common than any vascular contribution to dementia. (J Geriatr Psychiatry Neurol 2002; 15:000–000).
Get full access to this article
View all access options for this article.
References
1.
1. Lewy FH., Zur Pathologischen Anatomie der Paralysis agitans. Dtsch Ztschr Nervenheilk1913; 50: 50–55.
2.
2. Tretiakoff C., Contribution a l'etude de l'anatomie dulocus niger de Soemmering avec quelues deductions relative à la pathogenie des troubles du tonus musculaire et de la malaide de parkinson.Thèse de Paris, 1919.
3.
3. Lewy FH., Die Lehre vom tonus und der Bewegung. Zugleich systematische untersuchungen zur klinik, physiologie, pathologie and pathogenese der paralysis agitans. Berlin: Julius Springer, 1923.
4.
4. Forstl H, Levy R., FH Lewy on Lewy bodies, parkinsonism and dementia. Int J Geriatr Psychiatry1991; 6: 757–766.
5.
5. Okazaki H, Lipkin LE, Aronson SM., Diffuse intracytoplasmic ganglionic inclusions (Lewy type) associated with progressive dementia and quadriparesis in flexion. J Neuropathol Exp Neurol1961; 20: 237–244.
6.
6. Woodard JS., Concentric hyalin inclusion body formation in mental disease: analysis of twenty-seven cases. J Neuropathol Exp Neurol1962; 2: 442–449.
7.
7. Kosaka K., Lewy bodies in cerebral cortex. Report of three cases. Acta Neuropathol1978; 42: 127–134.
8.
8. Kosaka K, Matsushita M, Oyanagi S, et al., A clinicopathological study of “Lewy body disease.”Psychiatr Neurol Jpn1980; 82: 292–311.
9.
9. Kosaka K, Iseki E, Odawara T, et al., Cerebral type of Lewy body disease. Neuropathology1996; 16: 32–35.
10.
10. Yoshimura M., Cortical changes in the parkinsonian brain: a contribution to the delineation of ‘diffuse Lewy body disease.’ J Neurol1983; 229: 17–32.
11.
11. Byrne EJ, Lennox G, Lowe J, Godwin-Austen RB., Diffuse Lewy body disease: clinical features in 15 cases. J Neurol Neurosurg Psychiatry1989; 52: 709–717.
13. McKeith IG, Perry RH, Fairbairn AF, et al., Operational criteria for senile dementia of Lewy body type (SDLT). Psychol Med1992; 22: 911–922.
14.
14. Perry RH, Irving D, Blessed G, et al., Senile dementia of Lewy body type and spectrum of Lewy body disease. Lancet1989; 1: 1088.
15.
15. Perry RH, Irving D, Blessed G, et al., Senile dementia of Lewy body type. A clinically and neuropathologically distinct form of Lewy body dementia in the elderly. J Neurol Sci1990; 95: 119–139.
17. Hansen L, Salmon D, Galasko D, et al., Lewy body variant of Alzheimer's disease: a clinical and pathological entity. Neurology1990; 40: 1–8.
18.
18. McKeith IG, Galasko D, Kosaka K, et al., Consensus guidelines for the clinical and pathologic diagnosis of dementia with Lewy bodies (DLB): report of the consortium on DLB international workshop. Neurology1996; 47: 1113–1124.
19.
19. McKeith I., Dementia with Lewy bodies: a clinical overview. In: O'Brien J, Ames D, Burns A, eds., Dementia. 2nd Ed.New York: Oxford University Press, 2000: 685–697.
20.
20. Lindboe CF, Hansen HB., The frequency of Lewy bodies in a consecutive autopsy series. Clin Neuropathol1998; 17: 204–209.
21.
21. Jellinger KA., Structural basis of dementia in neurodegenerative disorders. J Neural Transm1996; 47: 1–29.
22.
22. Jellinger K, Danielczyk W, Fischer P, Gabriel E., Clinicopathological analysis of dementia disorders in the elderly. J Neurol Sci1990; 95: 239–258.
23.
23. Crystal HA, Dickson D, Davies P, et al., The relative frequency of “dementia of unknown etiology” increases with age and is nearly 50% in nonagenarians. Arch Neurol2000; 57: 713–719.
24.
24. Lennox G, Lowe J, Morrell K, et al., Antiubiquitin immunocytochemistry is more sensitive than conventional techniques in the detection of diffuse Lewy body disease. J Neurol Neurosurg Psychiatry1989; 52: 67–71.
25.
25. Spillantini MG, Schmidt ML, Lee VM, et al., Alpha-synuclein in Lewy bodies. Nature1997; 388: 839–840.
26.
26. Hansen LA, Masliah E, Galasko D, Terry RD., Plaque only Alzheimer disease is usually the Lewy body variant and vice versa. J Neuropathol Exp Neurol1993; 52: 648–654.
28. Hyman BT, Trojanowski JQ., Consensus recommendations for the postmortem diagnosis of Alzheimer disease from the National Institute on Aging and the Reagan Institute Working Group on diagnostic criteria for the neuropathological assessment of Alzheimer disease. J Neuropathol Exp Neurol1997; 56: 1095–1097.
29.
29. Hansen LA., Tautological tangles in neuropathologic criteria for dementias associated with Lewy bodies. In: Perry RH, McKeith IG, Perry EK, eds., Dementia with Lewy bodies: clinical, pathological, and treatment issues. Cambridge UK: Cambridge University Press, 1996: 204–223.
30.
30. Chui H., Vascular dementia, a new beginning: shifting focus from clinical phenotype to ischemic brain injury. Neurol Clin2000; 18: 951–978.
31.
31. Roman GC, Tatemichi TK, Erkinjuntti T, et al., Vascular dementia: diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop. Neurology1993; 43: 250–260.
32.
32. Joachim CL, Morris HJ, Selkoe DJ., Clinically diagnosed Alzheimer's disease: autopsy results in 150 cases. Ann Neurol1989; 24: 50–56.
33.
33. Drach LM, Steinmetz HE, Wach S, Bohl J., High proportion of dementia with Lewy bodies in the postmortems of a mental hospital in Germany. Int J Geriatr Psychiatry1997; 12: 301–306.
34.
34. Ince PG, McArthur FK, Bjertness E, et al., Neuropathological diagnoses in elderly patients in Oslo: Alzheimer's disease, Lewy body disease, vascular lesions. Dementia1995; 6: 162–168.
35.
35. Jellinger K., Frequency of “dementia of unknown etiology” increases with age. Arch Neurol2001; 58: 1498–1499.
36.
36. Lennox G, Lowe J, Landon M, et al., Diffuse Lewy body disease: correlative neuropathology using anti-ubiquitin immunocytochemistry. J Neurol Neurosurg Psychiatry1989; 52: 1236–1247.
37.
37. Lim A, Tsuang D, Kukull W, et al., Clinico-neuropathological correlation of Alzheimer's disease in a community-based series. J Am Geriatr Soc1999; 47: 564–569.
38.
38. Mirra SS, Heyman A, McKeel D, et al., The Consortium to Establish a Registry for Alzheimer's Disease (CERAD). Part II. Standardization of the neuropathologic assessment of Alzheimer's disease. Neurology1991; 41: 479–486.
39.
39. Holmes C, Cairns N, Lantos P, Mann A., Validity of current clinical criteria for Alzheimer's disease, vascular dementia and dementia with Lewy bodies. Br J Psychiatry1999; 174: 45–50.
40.
40. Neuropathology Group. Medical Research Council Cognitive Function and Aging Study. Pathological correlates of late-onset dementia in a multicentre, community-based population in England and Wales. Lancet2001; 357: 169–175.
41.
41. Nolan K, Lino MM, Seligmann AW, Blass J., Absence of vascular dementia in an autopsy series from a dementia clinic. J Am Geriatr Soc1998; 5: 597–604.
42.
42. Walker Z, Stevens T., Dementia with Lewy bodies: clinical characteristics and diagnostic criteria. J Geriatr Psychiatry Neurol2002; 15: 188–194.
43.
43. Collerton D, Davies C, Thompson P., Lewy body dementia in clinical practice. In: Perry RH, McKeith IG, Perry EK, eds., Dementia with Lewy bodies: clinical, pathological, and treatment issues. Cambridge (UK): Cambridge University Press, 1996: 171–186.
44.
44. Shergill S, Mullan E, D'Ath P, Katona C., What is the clinical prevalence of Lewy body dementia?Int J Geriatr Psychiatry1994; 9: 907–912.
45.
45. Ballard CG, Mohan RNC, Patel A, Bannister C., Idiopathic clouding of consciousness–do the patients have cortical Lewy body disease?Int J Geriatr Psychiatry1993; 8: 571–576.
46.
46. Clarfield AM., The reversible dementias: do they reverse?Ann Intern Med1988; 109: 476–486.
47.
47. Yamada T, Hattori H, Miura A, et al., Prevalence of Alzheimer's disease, vascular dementia and dementia with Lewy bodies in a Japanese population. Psychiatr Clin Neurosci2001; 55: 21–25.
48.
48. Hamilton RL., Lewy bodies in Alzheimer's disease: a neuropathological review of 145 cases using alpha-synuclein immunohistochemistry. Brain Pathol2000; 10: 378–384.
49.
49. Galasko D, Hansen L, Katzman R, et al., Clinical-neuropathological correlations in Alzheimer's disease and related dementias. Arch Neurol1994; 51: 888–895.
50.
50. Fratiglioni L, De Ronchi D, Aguero-Torres H., Worldwide prevalence and incidence of dementia. Drugs Aging1999; 15: 365–375.
