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Washington University Experience | NEURODEGENERATION | Lewy Body Disease (LBD) | 6 LBD - Microscopic Pathology - Cerebral Cortex | 11B Case 11 Denouement
Final Neuropathologic Diagnoses: Diffuse Lewy body disease; (Parkinson's disease/dementia with Lewy bodies, brain stem, limbic, and neocortical); Neurofibrillary tangles limited to medial temporal lobe ---- Comment: The main neuropathological finding correlated with the motor and cognitive changes is LBD – dementia, (aka at that time diffuse Lewy body disease, the pathological correlate of Parkinson's disease and dementia with Lewy bodies). In the revised criteria, which take into account the co-existence of Lewy body pathology and Alzheimer’s disease (AD) pathology, there is a 'high' probability that the cognitive impairment is caused by Lewy body pathology (McKeith et al, PMID: 16237129). In this case, no beta-amyloid plaques and no neuritic plaques were seen in the neocortex or elsewhere. Neurofibrillary tangles were most frequent in the medial temporal lobe in distributions and densities consistent with Braak and Braak neurofibrillary tangle stage I. The absence of beta-amyloid plaques and neuritic plaques excludes the neuropathological diagnosis of AD according to Khachaturian, CERAD, NIA-Reagan Institute, and NIA-AA criteria (A0,B1,C0). This is a clear case of “pure” LBD dementia.
