Neuropathology of prodromal Lewy body disease.
Mov Disord
; 29(3): 410-5, 2014 Mar.
Article
em En
| MEDLINE
| ID: mdl-24488760
ABSTRACT
BACKGROUND:
Current evidence suggests that there is a prodromal stage in Parkinson disease characterized by a variety of nonmotor symptoms. METHODS ANDRESULTS:
A 69-year-old man presented to our sleep center with isolated rapid eye movement sleep behavior disorder. During a 10-year follow-up period, longitudinal clinical and laboratory assessments indicated the development of hyposmia, depression, mild cognitive impairment, and constipation. Parkinsonism was absent, but dopamine transporter imaging showed subclinical substantia nigra damage. Postmortem examination demonstrated neuronal loss and Lewy body pathology in the peripheral autonomic nervous system (eg, cardiac and myenteric plexus), olfactory bulb, medulla, pons, substantia nigra pars compacta (estimated cell loss, 20%-30%), nucleus basalis of Meynert, and amygdala, sparing the neocortex.CONCLUSIONS:
Our observations indicate that nonmotor symptoms plus widespread peripheral and central nervous system pathological changes occur before parkinsonism and dementia onset in diseases associated with Lewy pathology. The current diagnostic criteria for Parkinson's disease miss these patients, who present only with nonmotor symptoms.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doença por Corpos de Lewy
/
Transtorno do Comportamento do Sono REM
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Aged80
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Humans
/
Male
Idioma:
En
Ano de publicação:
2014
Tipo de documento:
Article