New Information on the Early Stages of Dementia With Lewy Bodies

Summary: New findings reinforce the idea that dementia with Lewy bodies can be pathologically classified as two different and distinct disease types.

Source: University of Helsinki

Results obtained in a study recently completed at the University of Helsinki and Helsinki University Hospital reinforce the notion that dementia with Lewy bodies can be pathologically classified into two different disease types.

Dementia with Lewy bodies is the second most common neurodegenerative disease after Alzheimer’s disease, and it affects millions of people globally. This type of progressive memory disorder has features associated with both Alzheimer’s disease and Parkinson’s disease.

At the tissue level, accumulations known as Lewy bodies that contain the alpha-synuclein protein, are found in the limbic system of the brain, in the cerebral cortex and the brainstem.

Two years ago, researchers at the University of Helsinki and Helsinki University Hospital demonstrated that pathological changes of dementia with Lewy bodies occur in two different forms. In the more common form of the disease, changes progress upwards from the brainstem, while those associated with the other disease type originate in the amygdala.

Now, the researchers have advanced their investigations further.

“We continued our studies, focusing on the olfactory bulb in the brain. The olfactory bulb is considered one of the first brain regions where alpha-synuclein accumulations relating to dementia with Lewy bodies occur,” says Liisa Myllykangas, a neuropathologist and clinical instructor.

In the follow-up study, the researchers utilised a unique Finnish population-based neuropathological dataset (N=291). Alpha-synuclein accumulations in the olfactory bulb have not previously been investigated in non-selected population datasets.

This shows a brain
At the tissue level, accumulations known as Lewy bodies that contain the alpha-synuclein protein, are found in the limbic system of the brain, in the cerebral cortex and the brainstem. Image is in the public domain

Based on the results, two patterns of accumulations can be identified in the olfactory bulb, with differences seen in their anatomical location and severity.

“Comparing the findings with the two types of dementia with Lewy bodies defined in our prior study, we noted that the different alpha-synuclein accumulation patterns in the olfactory bulb have a strong association with these two disease types,” Myllykangas says.

The results support the view that the first changes caused by dementia with Lewy bodies take place in the olfactory bulb in persons whose disease progresses to the amygdala and the rest of the limbic system at an early stage. In contrast, the onset of the other disease type occurs in the brainstem, spreading later to the olfactory bulb. The findings reinforce the notion that dementia with Lewy bodies can be classified into two different disease types.

About this neurology research news

Author: Elina Kirvesniemi
Source: University of Helsinki
Contact: Elina Kirvesniemi – University of Helsinki
Image: The image is in the public domain

Original Research: Open access.
Alpha-synuclein pathology of olfactory bulbs/peduncles in the Vantaa85+ cohort exhibit two divergent patterns: a population-based study” by Liisa Myllykangas et al. Acta Neuropathologica


Abstract

Alpha-synuclein pathology of olfactory bulbs/peduncles in the Vantaa85+ cohort exhibit two divergent patterns: a population-based study

In Lewy body diseases, including Parkinson’s disease (PD) and dementia with Lewy bodies (DLB), alpha-synuclein accumulates intraneuronally in the central and peripheral nervous systems.

Recent studies have suggested that spread of alpha-synuclein positive Lewy-related pathology (LRP) follows two distinct patterns—caudo-rostral progression and an amygdala-based progression, the latter usually seen together with Alzheimer’s disease (AD) pathology.

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  1. I’m assuming that an origin in the brain stem corresponds to Parkinson’s that originates with aggregated alpha-synuclein in the gut and travels up the vagus nerve to the brain, while an origin in the olfactory bulb corresponds to Parkinson’s that originates with aggregated alpha-synuclein in the nose that crosses to the olfactory bulb via the cribiform plate. These are the two main pathways to so-called idiopathic Parkinson’s pee Braak’s hypothesis. So it appears that the pathways and timing of the spreading aggregated protein differbased on the port of entry. Probably this is what distinguishes Dementia with Lewy Bodies from Parkinson’s Dementia–it’s just a matter of whether the spreading blight reaches the cognitive areas or the nigrostriatal area first.

  2. As an 80 year young man ? graduate from college 3 years ago, life is different. No big medical problem but hand shakes. Intellect and intelligence as writer vital going into production videos? Yes! R.A.?

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