This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on Web of Science (2)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Alzheimer Disease  • Lewy Body Disease  • Alert me on articles by topic  Social Bookmarking   What's this?

Relation of Quantitative Indexes of Concurrent -Synuclein Abnormalities to Clinical Outcome in Autopsy-Proven Alzheimer Disease

Roee Holtzer, PhD; Michael C. Irizarry, MD; Jody Sanders, BA; Bradley T. Hyman, MD, PhD; Domonick J. Wegesin, PhD; Aliza Riba, BA; Jason Brandt, PhD; Marilyn Albert, PhD; Yaakov Stern, PhD

Arch Neurol. 2006;63:226-230.

Background  Lewy bodies (LBs) and Lewy neurites are frequent concomitant neuropathologic observations in clinical and neuropathologically defined Alzheimer disease (AD), but their relation to clinical features in AD is uncertain. Most studies used semiquantitative measures to determine the presence or absence of LB abnormalities.

Objective  To determine the clinical consequences of LB abnormalities in the setting of AD.

Design  Prospective study.

Setting  Three outpatient research and treatment centers.

Participants  Fourteen autopsy cases with a pathologic diagnosis of AD abnormalities and concomitant LBs followed semiannually for up to 8 years (mean age at intake, 72 years; mean age at death, 77 years; mean education, 15 years; 12 women).

Main Outcome Measures  The modified Mini-Mental State Examination was used to assess cognitive function. The Unified Parkinson Disease Rating Scale was used to rate extrapyramidal motor signs. Hallucinations were evaluated using the Columbia University Scale for Psychopathology in Alzheimer's Disease. Time from the first evaluation in which diagnostic criteria for probable AD were met to death was used to determine illness duration. Quantitative measures of LB abnormalities were obtained for the frontal cortex, entorhinal cortex, substantia nigra, and hippocampus.

Results  Independent-samples t tests were used to assess whether the degree of LB abnormality varied as a function of the presence or absence of hallucinations and extrapyramidal signs. Pearson r correlations were run to examine whether there was a relation among LB abnormalities, cognitive function, and illness duration. There was no relation between quantitative neuropathologic indexes of LB abnormalities and clinical outcome.

Conclusion  The variability of clinical features in AD was not related to the presence or degree of LB abnormalities.

Author Affiliations: Sergievsky Center (Drs Holtzer, Wegesin, and Stern and Ms Riba) and Departments of Neurology and Psychiatry (Dr Stern), Columbia University College of Physicians and Surgeons, New York, NY; Ferkauf Graduate School of Psychology and Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, New York (Dr Holtzer); Departments of Psychiatry and Neurology, Massachusetts General Hospital, Harvard Medical Center, Boston (Drs Irizzary, Hyman, and Albert and Ms Sanders); and Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Md (Dr Brandt).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?