title: Lewy body densities in the entorhinal and anterior cingulate cortex predict cognitive deficits in Parkinson's disease.
abstract: Previous studies reported an association between cortical Lewy body (LB) formation and dementia in Parkinson's disease (PD). However, it is unclear whether cognitive decline in this disorder is related to specific patterns of LB distribution within the cerebral cortex. Moreover, the prediction of cognitive status based on concomitant assessment of LB and Alzheimer's disease lesions has led to conflicting results. We performed a clinicopathological study in 22 elderly PD patients in whom parkinsonism preceded cognitive decline by at least 3 years. Cognitive status was assessed prospectively using the clinical dementia rating scale (CDR); quantitative assessment of LB, neurofibrillary tangles (NFT), and senile plaques (SP) was performed in Brodmann areas 9, 21, 24, 40 and the entorhinal cortex. Statistical analysis was performed using both correlation coefficients and logistic regression models. There was a highly significant correlation between CDR scores and regional LB scores in the entorhinal cortex and area 24. LB and SP densities in the entorhinal cortex accounted for 36.2% and 19.3% of the variability in CDR scores. LB densities in area 24 could explain 25.2% of this variability. NFT densities did not predict cognitive status. In multivariate models only LB densities in the entorhinal cortex and anterior cingulate cortex were significantly associated with CDR scores. These results imply that an assessment of LB pathology limited to the entorhinal cortex and area 24 may be sufficient to predict cognition in PD. They also suggest that LB formation in limbic areas may be crucial for the development of PD dementia.
authors.affiliation: Department of Psychiatry, HUG Belle-Idée, University of Geneva School of Medicine, Geneva, Switzerland. Eniko.Kovari@hcuge.ch
authors.forename: Enikö
authors.initials: E
authors.lastname: Kövari
authors.forename: Gabriel
authors.initials: G
authors.lastname: Gold
authors.forename: François R
authors.initials: FR
authors.lastname: Herrmann
authors.forename: Alessandra
authors.initials: A
authors.lastname: Canuto
authors.forename: Patrick R
authors.initials: PR
authors.lastname: Hof
authors.forename: Constantin
authors.initials: C
authors.lastname: Bouras
authors.forename: Panteleimon
authors.initials: P
authors.lastname: Giannakopoulos
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002452:Cell Count; D002540:Cerebral Cortex / Q000473:pathology*; D003072:Cognition Disorders / Q000378:metabolism / Q000473:pathology*; D018450:Disease Progression; D018728:Entorhinal Cortex / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006801:Humans; D016631:Lewy Bodies / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009419:Nerve Tissue Proteins / Q000378:metabolism; D016874:Neurofibrillary Tangles / Q000473:pathology; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000378:metabolism / Q000473:pathology*; D058225:Plaque, Amyloid / Q000473:pathology; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012723:Sex; D051843:Synucleins
chemical_list: D009419:Nerve Tissue Proteins; D051843:Synucleins