Lewy Body Pathology in Normal Elderly Subjects

• Published in: Journal of neuropathology and experimental neurology Vol. 68; no. 7; pp. 816 - 822
• Main Authors: Markesbery, William R, Jicha, Gregory A, Liu, Huaichen, Schmitt, Frederick A
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD American Association of Neuropathologists, Inc 01.07.2009; Lippincott Williams & Wilkins; Oxford University Press
• Subjects: Aged, 80 and over; alpha-Synuclein - metabolism; Biological and medical sciences; Brain - metabolism; Brain - pathology; Cognition; Female; Human viral diseases; Humans; Infectious diseases; Lewy Bodies - metabolism; Lewy Bodies - pathology; Longitudinal Studies; Male; Medical sciences; Neurofibrillary Tangles - pathology; Neurology; Neuropsychological Tests; Plaque, Amyloid - pathology; Socioeconomic Factors; Viral diseases; Viral diseases of the nervous system; Human; Anatomic pathology; Nervous system diseases; Senescence; Neurite; Lewy neurites; Aging; α-synucleinopathies; Elderly; Lewy body; Lewy bodies
• ISSN: 0022-3069; 1554-6578
• DOI: 10.1097/NEN.0b013e3181ac10a7

Lewy bodies and Lewy neurites are the hallmark neuropathologic findings in Parkinson disease, Parkinson disease with dementia, dementia with Lewy bodies, and other α-synucleinopathies. They have also been described in the brains of normal older individuals and referred to as incidental Lewy body disease. The purpose of this study was to determine the prevalence of Lewy bodies and Lewy neurites (Lewy body pathology [LBP]) in 139 autopsies from our normal volunteer control group of the University of Kentucky Alzheimer's Disease Center. All subjects were followed longitudinally and were cognitively normal and without any type of movement disorder, neuropsychiatric features, or other CNS findings. The brains of 33 of 139 normal subjects contained LBP in various regions. The most common regions involved were the medulla (26%), amygdala (24%), pons (20%), and midbrain (20%). No mean statistical differences were found between those with and without LBP on any demographic or cognitive variable, Braak stage, or neurofibrillary tangle and neuritic plaque quantitation. An explanation for the high prevalence of LBP in our elderly, well-educated study group is not clear, although it does not seem to be related to aging or the presence of Alzheimer disease pathology. Overall, our findings support the concept that incidental Lewy body disease most likely represents preclinical or presymptomatic Parkinson disease, Parkinson disease with dementia, or dementia with Lewy bodies.