Acta Neuropathologica

, Volume 115, Issue 4, pp 437–444

Evidence that incidental Lewy body disease is pre-symptomatic Parkinson’s disease

Authors

    • Neuropathology Laboratory, Department of NeuroscienceMayo Clinic
  • Hiroshige Fujishiro
    • Neuropathology Laboratory, Department of NeuroscienceMayo Clinic
  • Anthony DelleDonne
    • Neuropathology Laboratory, Department of NeuroscienceMayo Clinic
  • Joshua Menke
    • Neuropathology Laboratory, Department of NeuroscienceMayo Clinic
  • Zeshan Ahmed
    • Neuropathology Laboratory, Department of NeuroscienceMayo Clinic
  • Kevin J. Klos
    • Neurological Associates of Tulsa
  • Keith A. Josephs
    • Department of NeurologyMayo Clinic
  • Roberta Frigerio
    • Department of NeurologyMayo Clinic
  • Melinda Burnett
    • Department of NeurologyMayo Clinic
  • Joseph E. Parisi
    • Department of Pathology and Laboratory MedicineMayo Clinic
  • J. Eric Ahlskog
    • Department of NeurologyMayo Clinic
Original Paper

DOI: 10.1007/s00401-008-0345-7

Cite this article as:
Dickson, D.W., Fujishiro, H., DelleDonne, A. et al. Acta Neuropathol (2008) 115: 437. doi:10.1007/s00401-008-0345-7

Abstract

Lewy bodies, the histologic hallmark of Parkinson’s disease (PD), are detected in the brains of about 10% of clinically normal people over the age of 60 years. When Lewy bodies are found in normal individuals, the process is sometimes referred to as incidental Lewy body disease (iLBD). The distribution of Lewy bodies in iLBD is similar to the distribution in PD, but neuronal populations vulnerable to Lewy bodies do not show significant neuronal loss in iLBD. It remains unknown if Lewy bodies in this setting represent pre-symptomatic PD or an age-related change unrelated to PD. To address this question we identified cases of iLBD and used a marker for dopaminergic and noradrenergic neurons, tyrosine hydroxylase (TH), to determine if there were changes similar to those found in PD. TH immunoreactivity in the striatum and the epicardial nerve fibers was decreased in iLBD compared to normal controls, but not to the same extent as in PD. The findings suggest that iLBD is preclinical PD and that the lack of symptoms is due to subthreshold pathology.

Keywords

Immunohistochemistry Incidental Lewy bodies Heart Parkinson’s disease Striatum Tyrosine hydroxylase

Copyright information

© Springer-Verlag 2008