Cortical inflammation in Alzheimer disease but not dementia with Lewy bodies.
BACKGROUND
There have been no previous studies on the role of inflammation in the brain for the second most common dementing disorder, dementia with Lewy bodies.


OBJECTIVE
To investigate the degree of cortical inflammation in dementia with Lewy bodies (DLB) compared with Alzheimer disease (AD) and control brains.


METHODS
Post-mortem tissue collection from a brain donor program using standardized diagnostic criteria. Brains collected from January 1, 1993, through December 31, 1996, were screened and selected only for the presence or absence of tau neuritic plaques. Results of immunohistochemistry for HLA-DR were quantified using area fraction counts. Counts were performed by investigators who were unaware of the diagnosis. Results were compared across groups using analysis of variance and posthoc testing.


METHODS
A medical research institute in Sydney, Australia.


METHODS
Eight brains with DLB and without the tau neuritic plaques typical of AD, 10 brains with AD and no Lewy bodies, and 11 nondemented controls without significant neuropathological features were selected from a consecutive sample.


RESULTS
Compared with AD, DLB demonstrated significantly less inflammation in the form of HLA-DR-reactive microglia in all cortical regions (P<.001, posthoc). The level of inflammation in DLB was comparable to that seen in controls (P=.54, post hoc).


CONCLUSIONS
Inflammation appears related to the tau neuritic plaques of AD. Despite similar clinical presentations, therapeutic anti-inflammatory strategies are not likely to be effective for pure DLB. Arch Neurol. 2000.
Shepherd
C E
CE
Prince of Wales Medical Research Institute, High Street, Randwick, New South Wales 2031, Australia.
Thiel
E
E
McCann
H
H
Harding
A J
AJ
Halliday
G M
GM
D000368:Aged; D000544:Alzheimer Disease / Q000473:pathology*; D001315:Australia; D001344:Autopsy; D002540:Cerebral Cortex / Q000473:pathology*; D005260:Female; D006684:HLA-DR Antigens / Q000032:analysis; D006801:Humans; D007150:Immunohistochemistry; D007249:Inflammation / Q000473:pathology*; D020961:Lewy Body Disease / Q000473:pathology*; D008297:Male; D058225:Plaque, Amyloid / Q000473:pathology; D016875:tau Proteins / Q000378:metabolism
D006684:HLA-DR Antigens; D016875:tau Proteins