RESUMO
AIMS: Complex visual hallucinations occur in 70% of dementia with Lewy bodies (DLB) cases and significantly affect patient well-being. Visuo-cortical and retinal abnormalities have been recorded in DLB and may play a role in visual hallucinations. The present study aimed to investigate the lateral geniculate nucleus (LGN), a visual relay centre between the retina and visual cortex, to see if changes to this structure underlie visual hallucinations in DLB. METHODS: Fifty-one [17 probable DLB, 19 control and 15 probable Alzheimer's disease (AD)] cases were recruited for a functional magnetic resonance imaging study, in which patients' response to a flashing checkerboard stimulus was detected and measured in the LGN, before comparison across experimental groups. Additionally, post mortemâ LGN tissue was acquired for a cross-sectional study using 20 (six DLB, seven control and seven AD) cases and analysed using stereology. α-Synuclein, phosphorylated tau and amyloid-ß pathology was also assessed in all cases. RESULTS: DLB cases did not significantly differ from controls on neuroimaging, morphometry or pathology. However, a significant increase in amyloid-ß pathology, a reduction in number of parvocellular neurones and magnocellular gliosis was found in AD cases compared with control and DLB cases. CONCLUSIONS: These findings suggest that the early visual system is relatively spared in DLB, which implies that upstream visual structures may be largely responsible for the generation of hallucinatory percepts. The significance of the degeneration of the LGN in AD cases is uncertain.
Assuntos
Doença de Alzheimer/patologia , Doença de Alzheimer/fisiopatologia , Corpos Geniculados/patologia , Corpos Geniculados/fisiopatologia , Doença por Corpos de Lewy/patologia , Doença por Corpos de Lewy/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , Mapeamento Encefálico , Estudos Transversais , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Estimulação LuminosaRESUMO
Previous imaging and morphometric studies have identified volumetric and cellular abnormalities in prefrontal areas in late-life depression. This study aimed to examine cellular morphology using stereological methodology in the supragenual region of the anterior cingulate cortex in late-life depressed patients compared with age-matched controls. Post-mortem tissue was acquired from nine patients with depression and 11 control patients and analyzed using the optical disector and nucleator methods. No changes were found in glial, non-pyramidal and pyramidal cell density, or in non-pyramidal or pyramidal cell volume within individual layers (2-5) or the supragenual anterior cortex as a whole. This study, therefore, does not provide further evidence for cellular abnormalities in late-life depression.