Summary.
The frequency of vascular lesions in dementia with Lewy bodies (DLB) has been suggested to be less common than for Parkinson disease (PD), but exact data on the relationship between DLB and stroke are not available. 387 consecutive cases of autopsy-proven Lewy body disease – 291 cases of idiopathic PD (Lewy body disease of brainstem type) and 96 cases of DLB – and 390 age-matched controls were compared using current routine stains and immunohistological methods. The frequency of cerebrovascular lesions of various intensity (lacunes, amyloid angiopathy, old ischemic infarcts and hemorrhages) was lower in DLB than in both PD and controls (34.4% vs. 36.7% and 33.3%) (p > 0.03). While acute ischemic strokes and hemorrhages were rarely present in both PD and controls (4.1 vs. 3.3%), no such lesions were observed in DLB. At variance to previous findings in autopsy-proven PD and Alzheimer disease (AD), these data suggest a protective effect against stroke and no greater susceptibility to death from stroke in the DLB population studied, but the reasons remain unclear. On the other hand, like in PD and AD, cognitive impairment in DLB appears to be independent from coexisting vascular pathology and is mainly related to neuritic Alzheimer pathology.
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Received November 5, 2002; accepted February 12, 2003 Published online April 22, 2003
Acknowledgements We thank the medical staff of Lainz Hospital, Wienerwald Geriatric Hospital, and Otto-Wagner Hospital, Vienna, for the clinical and neuropsychological data, the pathologists of all three hospitals for autopsy reports and brain material, Mrs. V. Rappelsberger for excellent laboratory work, and E. Mitter-Ferstl, PhD, for secretarial and computer work. Part of the study was granted by the Society for the Support of Research in the Field of Experimental Neurology, Vienna, Austria.
Author's address: K. A. Jellinger, MD, Institute of Clinical Neurobiology, Kenyongasse 18, A-1070 Vienna, Austria, e-mail: kurt.jellinger@univie.ac.at
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Jellinger, K. Prevalence of vascular lesions in Dementia with Lewy Bodies. A postmortem study. J Neural Transm 110, 771–778 (2003). https://doi.org/10.1007/s00702-003-0824-x
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DOI: https://doi.org/10.1007/s00702-003-0824-x