Original Paper

Acta Neuropathologica

, Volume 115, Issue 4, pp 445-451

First online:

Reduced striatal tyrosine hydroxylase in incidental Lewy body disease

  • Thomas Gerald BeachAffiliated withSun Health Research Institute Email author 
  • , Charles H. AdlerAffiliated withDepartment of Neurology, Mayo Clinic
  • , Lucia I. SueAffiliated withSun Health Research Institute
  • , Jeffrey B. PeirceAffiliated withSun Health Research Institute
  • , Jyothi BachalakuriAffiliated withSun Health Research Institute
  • , Jessica E. Dalsing-HernandezAffiliated withSun Health Research Institute
  • , Lih Fen LueAffiliated withSun Health Research Institute
  • , John N. CavinessAffiliated withDepartment of Neurology, Mayo Clinic
  • , Donald J. ConnorAffiliated withSun Health Research Institute
    • , Marwan N. SabbaghAffiliated withSun Health Research Institute
    • , Douglas G. WalkerAffiliated withSun Health Research Institute

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Incidental Lewy body disease (ILBD) is the term used when Lewy bodies are found in the nervous system of subjects without clinically documented parkinsonism or dementia. The prevalence of ILBD in the elderly population has been estimated at between 3.8 and 30%, depending on subject age and anatomical site of sampling. It has been speculated that ILBD represents the preclinical stage of Parkinson’s disease (PD) and/or dementia with Lewy bodies (DLB). Studies of ILBD could potentially identify early diagnostic signs of these disorders. At present, however, it is impossible to know whether ILBD is a precursor to PD or DLB or is just a benign finding of normal aging. We hypothesized that, if ILBD represents an early stage of PD or DLB, it should be associated with depletion of striatal dopaminergic markers. Eleven subjects with ILBD and 27 control subjects were studied. The ILBD subjects ranged in age from 74 to 96 years (mean 86.5) while the control subjects’ age ranged from 75 to 102 years (mean 86.7). Controls and subjects did not differ in terms of age, postmortem interval, gender distribution, medical history conditions, brain weight, neuritic plaque density or Braak neurofibrillary stage. Quantitative ELISA measurement of striatal tyrosine hydroxylase (TH), the principal enzyme for dopamine synthesis, showed a 49.8% (P = 0.01) reduction in ILBD cases, as compared with control cases. The finding suggests that ILBD is not a benign condition but is likely a precursor to PD and/or DLB.


Striatum Dopamine Parkinson’s disease Lewy bodies Pathogenesis Aging