Contribution of Lewy Body Inclusions to Dementia in Patients With and Without Alzheimer Disease Neuropathological Conditions

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Abstract
THE RELATIONSHIP between Parkinson disease (PD) and Alzheimer disease (AD) has sparked a great deal of interest because of the overlapping features of these 2 disorders. There appears to be a continuum of deficits ranging from pure movement disorder (PD) to pure dementia (AD), with a large number of cases manifesting combined cognitive and extrapyramidal changes.1,2 Classically, the neuropathological presentation of PD is marked by the presence of the intracellular inclusions called Lewy bodies (LBs), located in the substantia nigra,3 while AD is marked by the hallmark neuritic plaques (NPs) and neurofibrillary tangles (NFTs).4,5 Lewy bodies may or may not coexist in the cortex with NPs and NFTs.6-8 A case of dementia with LBs but no AD changes in the cortex is referred to as "pure" diffuse Lewy body dementia (DLBD).2,9 The co-occurrence of plaques, however, may change the diagnosis to either the common form of DLBD or the Lewy body variant (LBV) of AD.10-12