Relation of quantitative indexes of concurrent alpha-synuclein abnormalities to clinical outcome in autopsy-proven Alzheimer disease.
BACKGROUND
Lewy bodies (LBs) and Lewy neurites are frequent concomitant neuropathologic observations in clinical and neuropathologically defined Alzheimer disease (AD), but their relation to clinical features in AD is uncertain. Most studies used semiquantitative measures to determine the presence or absence of LB abnormalities.


OBJECTIVE
To determine the clinical consequences of LB abnormalities in the setting of AD.


METHODS
Prospective study.


METHODS
Three outpatient research and treatment centers.


METHODS
Fourteen autopsy cases with a pathologic diagnosis of AD abnormalities and concomitant LBs followed semiannually for up to 8 years (mean age at intake, 72 years; mean age at death, 77 years; mean education, 15 years; 12 women).


METHODS
The modified Mini-Mental State Examination was used to assess cognitive function. The Unified Parkinson Disease Rating Scale was used to rate extrapyramidal motor signs. Hallucinations were evaluated using the Columbia University Scale for Psychopathology in Alzheimer's Disease. Time from the first evaluation in which diagnostic criteria for probable AD were met to death was used to determine illness duration. Quantitative measures of LB abnormalities were obtained for the frontal cortex, entorhinal cortex, substantia nigra, and hippocampus.


RESULTS
Independent-samples t tests were used to assess whether the degree of LB abnormality varied as a function of the presence or absence of hallucinations and extrapyramidal signs. Pearson r correlations were run to examine whether there was a relation among LB abnormalities, cognitive function, and illness duration. There was no relation between quantitative neuropathologic indexes of LB abnormalities and clinical outcome.


CONCLUSIONS
The variability of clinical features in AD was not related to the presence or degree of LB abnormalities.
Holtzer
Roee
R
Sergievsky Center, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA.
Irizarry
Michael C
MC
Sanders
Jody
J
Hyman
Bradley T
BT
Wegesin
Domonick J
DJ
Riba
Aliza
A
Brandt
Jason
J
Albert
Marilyn
M
Stern
Yaakov
Y
D000368:Aged; D000544:Alzheimer Disease / Q000473:pathology*; D001344:Autopsy; D015415:Biomarkers / Q000032:analysis*; D001921:Brain / Q000473:pathology; D005260:Female; D006801:Humans; D016631:Lewy Bodies / Q000737:chemistry / Q000473:pathology*; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D051844:alpha-Synuclein / Q000032:analysis*
D015415:Biomarkers; D051844:alpha-Synuclein