Lewy bodies in cerebral cortex. Report of three cases
Received: 02 November 1977 Accepted: 28 February 1978 DOI:
Cite this article as: Kosaka, K. Acta Neuropathol (1978) 42: 127. doi:10.1007/BF00690978 Summary
The histochemical and structural properties and the topographical distribution pattern of Lewy bodies in the cerebral cortex as well as in the brain stem and diencephalon were studied in three cases.
The Lewy bodies in the cerebral cortex were found in the small or medium-sized neurons of the fifth and sixth layers, particularly in the anterior frontal, temporal, insular, and cingulate cortex, and showed minor differences in their histochemical and structural properties from typical Lewy bodies in the brain stem and diencephalon. By light microscopy they were more irregular in shape, less eosinophilic, less sharply demarcated, and did not have clear halos and central cores. From the ultrastructural aspect, the filaments in them did not radiate, but were arranged at random, and circular profiles were not associated in the central zone. This type of Lewy body was also distributed in the basal ganglia. A close relationship between Lewy bodies and monoamines in the cerebral cortex of our cases was not recognized. These three cases showed also concomitant senile changes, i.e., senile plaques and neurofibrillary tangles.
Key words Lewy body “Cerebral type” of Lewy body Monoamines Dementia Senile changes
Supported in part by a scholarship in Max-Planck-Institut für Psychiatrie (München)
Andén, N. E., Dahlström, A., Fuxe, K., Larsson, K.: Mapping out of catecholamine and 5-hydroxytryptamine neurons innervating the telencephalon and diencephalon. Life Sci.
, 1275–1279 (1965)
Battista, A., Fuxe, K., Goldstein, M., Ogawa, M.: Mapping of central monoamine neurons in the monkey. Experientia (Basel).
, 688–690 (1972)
Berger, B., Tassin, J. P., Blanc, G., Moyne, M. A., Thierry, A. M.: Histochemical confirmation for dopaminergic innervation of the rat cerebral cortex after destruction of the noradrenergic ascending pathways. Brain Res.
, 332–337 (1974)
Berger, B., Thierry, A. M., Tassin, J. P., Moyne, M. A.: Dopaminergic innervation of the rat prefrontal cortex; A fluorescence histochemical study. Brain Res.
, 133–145 (1976)
den Hartog Jager, W. A., Bethlem, J.: The distribution of Lewy bodies in the central and autonomic nervous system in idiopathic paralysis agitans. J. Neurol. Neurosurg. Psychiat.
, 283–290 (1960)
Descarries, L., Beaudet, A., Watkins, K. C.: Serotonin nerve terminals in adult rat neocortex. Brain Res.
, 563–588 (1975)
Duffy, P. E., Tennyson, V. M.: Phase and electron microscopic observations of Lewy bodies and melanin granules in the substantia nigra and locus coeruleus in the Parkinson's disease. J. Neuropath. exp. Neurol.
, 398–414 (1965)
Farley, I. J., Hornykiewicz, O.: Noradrenaline distribution in subcortical areas of the human brain. Brain Res.
, 53–62 (1977)
Forno, L. S.: Concentric hyalin intraneuronal inclusions of Lewy type in the brains of elderly persons (50 incidental cases): Relationship to parkinsonism. J. Amer. Geriat. Soc.
, 557–575 (1969)
Fuxe, K.: Evidence for the existence of monoamine neurons in the central nervous system. IV. The distribution of monoamine nerve terminals in the central nervous system. Acta Physiol. Scand.
, Suppl. 247, 37–85 (1965)
Greenfield, J. G., Bosanquet, F. D.: The brain stem lesions in parkinsonism. J. Neurol. Neurosurg. Psychiat.
, 213–226 (1953)
Hökfelt, T., Fuxe, K., Johansson, O., Ljugdahl, A.: Pharmacohistochemical evidence of the existence of dopamine nerve terminals in the limbic cortex. Europ. J. Pharmacol.
, 108–112 (1974)
Ikeda, K., Yoshimura, T., Kato, H.: A case of idiopathic parkinsonism with many Lewy bodies in the cerebral cortex. Brain and Nerve.
, 733–742 (1975)
Kosaka, K., Oyanagi, S., Matsushita, M., Hori, A., Iwase, S.: Presenile dementia with Alzheimer-, Pick- and Lewy-body changes. Acta neuropath. (Berl.)
, 221–233 (1976)
Lapierre, Y., Beaudet, A., Demianczuk, N., Descarries, L.: Noradrenergic axon terminals in the cerebral cortex of rat. II. Quantitative data revealed by light and electron microscope radiography of the frontal cortex. Brain Res.
, 175–182 (1973)
Lewy, F. H.: Paralysis agitans; I. Pathologische Anatomie. In: Handbuch der Neurologie (ed. M. Lewandowsky), Vol. 3, pp. 920–933. Berlin: Springer 1912
Lindvall, O., Björklund, A., Moore, R. Y., Stenevi, U.: Mesencephalic dopamine neurons projecting to neocortex. Brain Res.
, 325–331 (1974)
Lipkin, L. E.: Cytoplasmic inclusions in ganglion cells associated with Parkinsonian states. A neurocellular change studied in 53 cases and 206 control. Amer. J. Path.
, 1117–1133 (1959)
Nyström, B., Olson, L., Ungerstedt, U.: Noradrenaline nerve terminals in human cerebral cortices; First histochemical evidence. Science
, 924–926 (1972)
Ohama, E., Ikuta, F.: Parkinson's disease; Distribution of Lewy bodies and monoamine neuron system. Acta neuropath. (Berl.)
, 311–319 (1976)
Okazaki, H., Lipkin, L. E., Aronson, S. M.: Diffuse intracytoplasmic ganglionic inclusions (Lewy type) associated with progressive dementia and quadriparesis in flexion. J. Neuropath. Exp. Neurol.
, 237–244 (1961)
Olson, L., Nyström, B., Seiger, A.: Monoamine fluorescence histochemistry of human postmortem brain. Brain Res.
, 231–247 (1973)
Oyanagi, S.: An electron microscopic observation on senile dementia, with special references to transformation of neurofilaments to twisted tubles and a structural connection of Pick bodies to Alzheimer's neurofibrillary changes. Advanc. Neurol. Sci.
, 77–88, (1974)
Roy, S., Wolman, T.: Ultrastructural observations in Parkinsonism. J. Path.
, 39–44 (1969)
Schochet, S. S., Jr.: Neuronal inclusions. In: The structure and function of nervous tissue. Vol. 4 (Ed. G. H. Bourne). New York: Academic Press 1972
Thierry, A. M., Stinus, L., Blanc, G., Glowinski, J.: Some evidence for the existence of dopaminergic neurons in the rat cortex. Brain Res.
, 230–234 (1973)
Versteeg, D. H. G., Van der Gugten, J., De Jong, W., Parkovits, M.: Regional concentrations of noradrenaline in rat brain. Brain Res.
, 563–574 (1976)
Wisniewski, H. M., Coblentz, J. M., Terry, R. D.: Pick's disease. A clinical and ultrastructural study. Arch. Neurol. (Chicago)
, 97–108 (1972)