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Forrest SL, Crockford DR, Sizemova A, McCann H, Shepherd CE, McGeachie AB, Affleck AJ, Carew-Jones F, Bartley L, Kwok JB, Kim WS, Jary E, Tan RH, McGinley CV, Piguet O, Hodges JR, Kril JJ, Halliday GM. Coexisting Lewy body disease and clinical parkinsonism in frontotemporal lobar degeneration. Neurology 2019; 92:e2472-e2482. [PMID: 31019099 DOI: 10.1212/wnl.0000000000007530] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 01/23/2019] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To investigate the prevalence of clinically relevant multiple system atrophy (MSA) and Lewy body disease (LBD) pathologies in a large frontotemporal lobar degeneration (FTLD) cohort to determine if concomitant pathologies underlie the heterogeneity of clinical features. METHODS All prospectively followed FTLD-tau and FTLD-TDP cases held by the Sydney Brain Bank (n = 126) were screened for coexisting MSA and LBD (Braak ≥ stage IV) pathology. Relevant clinical (including family history) and genetic associations were determined. RESULTS MSA pathology was not identified in this series. Of the FTLD cohort, 9 cases had coexisting LBD ≥ Braak stage IV and were associated with different FTLD subtypes including Pick disease (n = 2), corticobasal degeneration (n = 2), progressive supranuclear palsy (n = 2), and TDP type A (n = 3). All FTLD-TDP cases with coexisting LBD had mutations in progranulin (n = 2) or an abnormal repeat expansion in C9orf72 (n = 1). All FTLD-tau cases with coexisting LBD were sporadic. The H1H1 MAPT haplotype was found in all cases that could be genotyped (n = 6 of 9). Seven cases presented with a predominant dementia disorder, 3 of which developed parkinsonism. Two cases presented with a movement disorder and developed dementia in their disease course. The age at symptom onset (62 ± 11 years) and disease duration (8 ± 5 years) in FTLD cases with coexisting LBD did not differ from pure FTLD or pure LBD cases in the brain bank. CONCLUSION Coexisting LBD in FTLD comprises a small proportion of cases but has implications for clinical and neuropathologic diagnoses and the identification of biomarkers.
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Affiliation(s)
- Shelley L Forrest
- From the Discipline of Pathology (S.L.F., D.R.C., A.S., C.V.M., J.J.K.), Central Clinical School (J.B.K., W.S.K., E.J., R.H.T., J.R.H., G.M.H.), Faculty of Medicine and Health, Brain and Mind Centre (J.B.K., W.S.K., E.J., R.H.T., O.P., J.R.H., G.M.H.), and School of Psychology (O.P.), The University of Sydney; Neuroscience Research Australia (H.M., C.E.S., A.B.M., A.J.A., F.C.-J., L.B., J.B.K., W.S.K., E.J., R.H.T., O.P., J.R.H., G.M.H.), Sydney; School of Medical Sciences (C.E.S., A.J.A., F.C.-J., J.B.K., W.S.K., R.H.T., G.M.H.), University of New South Wales; and ARC Centre of Excellence in Cognition and its Disorders (O.P., J.R.H.), Sydney, Australia
| | - Daniel R Crockford
- From the Discipline of Pathology (S.L.F., D.R.C., A.S., C.V.M., J.J.K.), Central Clinical School (J.B.K., W.S.K., E.J., R.H.T., J.R.H., G.M.H.), Faculty of Medicine and Health, Brain and Mind Centre (J.B.K., W.S.K., E.J., R.H.T., O.P., J.R.H., G.M.H.), and School of Psychology (O.P.), The University of Sydney; Neuroscience Research Australia (H.M., C.E.S., A.B.M., A.J.A., F.C.-J., L.B., J.B.K., W.S.K., E.J., R.H.T., O.P., J.R.H., G.M.H.), Sydney; School of Medical Sciences (C.E.S., A.J.A., F.C.-J., J.B.K., W.S.K., R.H.T., G.M.H.), University of New South Wales; and ARC Centre of Excellence in Cognition and its Disorders (O.P., J.R.H.), Sydney, Australia
| | - Anastasia Sizemova
- From the Discipline of Pathology (S.L.F., D.R.C., A.S., C.V.M., J.J.K.), Central Clinical School (J.B.K., W.S.K., E.J., R.H.T., J.R.H., G.M.H.), Faculty of Medicine and Health, Brain and Mind Centre (J.B.K., W.S.K., E.J., R.H.T., O.P., J.R.H., G.M.H.), and School of Psychology (O.P.), The University of Sydney; Neuroscience Research Australia (H.M., C.E.S., A.B.M., A.J.A., F.C.-J., L.B., J.B.K., W.S.K., E.J., R.H.T., O.P., J.R.H., G.M.H.), Sydney; School of Medical Sciences (C.E.S., A.J.A., F.C.-J., J.B.K., W.S.K., R.H.T., G.M.H.), University of New South Wales; and ARC Centre of Excellence in Cognition and its Disorders (O.P., J.R.H.), Sydney, Australia
| | - Heather McCann
- From the Discipline of Pathology (S.L.F., D.R.C., A.S., C.V.M., J.J.K.), Central Clinical School (J.B.K., W.S.K., E.J., R.H.T., J.R.H., G.M.H.), Faculty of Medicine and Health, Brain and Mind Centre (J.B.K., W.S.K., E.J., R.H.T., O.P., J.R.H., G.M.H.), and School of Psychology (O.P.), The University of Sydney; Neuroscience Research Australia (H.M., C.E.S., A.B.M., A.J.A., F.C.-J., L.B., J.B.K., W.S.K., E.J., R.H.T., O.P., J.R.H., G.M.H.), Sydney; School of Medical Sciences (C.E.S., A.J.A., F.C.-J., J.B.K., W.S.K., R.H.T., G.M.H.), University of New South Wales; and ARC Centre of Excellence in Cognition and its Disorders (O.P., J.R.H.), Sydney, Australia
| | - Claire E Shepherd
- From the Discipline of Pathology (S.L.F., D.R.C., A.S., C.V.M., J.J.K.), Central Clinical School (J.B.K., W.S.K., E.J., R.H.T., J.R.H., G.M.H.), Faculty of Medicine and Health, Brain and Mind Centre (J.B.K., W.S.K., E.J., R.H.T., O.P., J.R.H., G.M.H.), and School of Psychology (O.P.), The University of Sydney; Neuroscience Research Australia (H.M., C.E.S., A.B.M., A.J.A., F.C.-J., L.B., J.B.K., W.S.K., E.J., R.H.T., O.P., J.R.H., G.M.H.), Sydney; School of Medical Sciences (C.E.S., A.J.A., F.C.-J., J.B.K., W.S.K., R.H.T., G.M.H.), University of New South Wales; and ARC Centre of Excellence in Cognition and its Disorders (O.P., J.R.H.), Sydney, Australia
| | - Andrew B McGeachie
- From the Discipline of Pathology (S.L.F., D.R.C., A.S., C.V.M., J.J.K.), Central Clinical School (J.B.K., W.S.K., E.J., R.H.T., J.R.H., G.M.H.), Faculty of Medicine and Health, Brain and Mind Centre (J.B.K., W.S.K., E.J., R.H.T., O.P., J.R.H., G.M.H.), and School of Psychology (O.P.), The University of Sydney; Neuroscience Research Australia (H.M., C.E.S., A.B.M., A.J.A., F.C.-J., L.B., J.B.K., W.S.K., E.J., R.H.T., O.P., J.R.H., G.M.H.), Sydney; School of Medical Sciences (C.E.S., A.J.A., F.C.-J., J.B.K., W.S.K., R.H.T., G.M.H.), University of New South Wales; and ARC Centre of Excellence in Cognition and its Disorders (O.P., J.R.H.), Sydney, Australia
| | - Andrew J Affleck
- From the Discipline of Pathology (S.L.F., D.R.C., A.S., C.V.M., J.J.K.), Central Clinical School (J.B.K., W.S.K., E.J., R.H.T., J.R.H., G.M.H.), Faculty of Medicine and Health, Brain and Mind Centre (J.B.K., W.S.K., E.J., R.H.T., O.P., J.R.H., G.M.H.), and School of Psychology (O.P.), The University of Sydney; Neuroscience Research Australia (H.M., C.E.S., A.B.M., A.J.A., F.C.-J., L.B., J.B.K., W.S.K., E.J., R.H.T., O.P., J.R.H., G.M.H.), Sydney; School of Medical Sciences (C.E.S., A.J.A., F.C.-J., J.B.K., W.S.K., R.H.T., G.M.H.), University of New South Wales; and ARC Centre of Excellence in Cognition and its Disorders (O.P., J.R.H.), Sydney, Australia
| | - Francine Carew-Jones
- From the Discipline of Pathology (S.L.F., D.R.C., A.S., C.V.M., J.J.K.), Central Clinical School (J.B.K., W.S.K., E.J., R.H.T., J.R.H., G.M.H.), Faculty of Medicine and Health, Brain and Mind Centre (J.B.K., W.S.K., E.J., R.H.T., O.P., J.R.H., G.M.H.), and School of Psychology (O.P.), The University of Sydney; Neuroscience Research Australia (H.M., C.E.S., A.B.M., A.J.A., F.C.-J., L.B., J.B.K., W.S.K., E.J., R.H.T., O.P., J.R.H., G.M.H.), Sydney; School of Medical Sciences (C.E.S., A.J.A., F.C.-J., J.B.K., W.S.K., R.H.T., G.M.H.), University of New South Wales; and ARC Centre of Excellence in Cognition and its Disorders (O.P., J.R.H.), Sydney, Australia
| | - Lauren Bartley
- From the Discipline of Pathology (S.L.F., D.R.C., A.S., C.V.M., J.J.K.), Central Clinical School (J.B.K., W.S.K., E.J., R.H.T., J.R.H., G.M.H.), Faculty of Medicine and Health, Brain and Mind Centre (J.B.K., W.S.K., E.J., R.H.T., O.P., J.R.H., G.M.H.), and School of Psychology (O.P.), The University of Sydney; Neuroscience Research Australia (H.M., C.E.S., A.B.M., A.J.A., F.C.-J., L.B., J.B.K., W.S.K., E.J., R.H.T., O.P., J.R.H., G.M.H.), Sydney; School of Medical Sciences (C.E.S., A.J.A., F.C.-J., J.B.K., W.S.K., R.H.T., G.M.H.), University of New South Wales; and ARC Centre of Excellence in Cognition and its Disorders (O.P., J.R.H.), Sydney, Australia
| | - John B Kwok
- From the Discipline of Pathology (S.L.F., D.R.C., A.S., C.V.M., J.J.K.), Central Clinical School (J.B.K., W.S.K., E.J., R.H.T., J.R.H., G.M.H.), Faculty of Medicine and Health, Brain and Mind Centre (J.B.K., W.S.K., E.J., R.H.T., O.P., J.R.H., G.M.H.), and School of Psychology (O.P.), The University of Sydney; Neuroscience Research Australia (H.M., C.E.S., A.B.M., A.J.A., F.C.-J., L.B., J.B.K., W.S.K., E.J., R.H.T., O.P., J.R.H., G.M.H.), Sydney; School of Medical Sciences (C.E.S., A.J.A., F.C.-J., J.B.K., W.S.K., R.H.T., G.M.H.), University of New South Wales; and ARC Centre of Excellence in Cognition and its Disorders (O.P., J.R.H.), Sydney, Australia
| | - Woojin Scott Kim
- From the Discipline of Pathology (S.L.F., D.R.C., A.S., C.V.M., J.J.K.), Central Clinical School (J.B.K., W.S.K., E.J., R.H.T., J.R.H., G.M.H.), Faculty of Medicine and Health, Brain and Mind Centre (J.B.K., W.S.K., E.J., R.H.T., O.P., J.R.H., G.M.H.), and School of Psychology (O.P.), The University of Sydney; Neuroscience Research Australia (H.M., C.E.S., A.B.M., A.J.A., F.C.-J., L.B., J.B.K., W.S.K., E.J., R.H.T., O.P., J.R.H., G.M.H.), Sydney; School of Medical Sciences (C.E.S., A.J.A., F.C.-J., J.B.K., W.S.K., R.H.T., G.M.H.), University of New South Wales; and ARC Centre of Excellence in Cognition and its Disorders (O.P., J.R.H.), Sydney, Australia
| | - Eve Jary
- From the Discipline of Pathology (S.L.F., D.R.C., A.S., C.V.M., J.J.K.), Central Clinical School (J.B.K., W.S.K., E.J., R.H.T., J.R.H., G.M.H.), Faculty of Medicine and Health, Brain and Mind Centre (J.B.K., W.S.K., E.J., R.H.T., O.P., J.R.H., G.M.H.), and School of Psychology (O.P.), The University of Sydney; Neuroscience Research Australia (H.M., C.E.S., A.B.M., A.J.A., F.C.-J., L.B., J.B.K., W.S.K., E.J., R.H.T., O.P., J.R.H., G.M.H.), Sydney; School of Medical Sciences (C.E.S., A.J.A., F.C.-J., J.B.K., W.S.K., R.H.T., G.M.H.), University of New South Wales; and ARC Centre of Excellence in Cognition and its Disorders (O.P., J.R.H.), Sydney, Australia
| | - Rachel H Tan
- From the Discipline of Pathology (S.L.F., D.R.C., A.S., C.V.M., J.J.K.), Central Clinical School (J.B.K., W.S.K., E.J., R.H.T., J.R.H., G.M.H.), Faculty of Medicine and Health, Brain and Mind Centre (J.B.K., W.S.K., E.J., R.H.T., O.P., J.R.H., G.M.H.), and School of Psychology (O.P.), The University of Sydney; Neuroscience Research Australia (H.M., C.E.S., A.B.M., A.J.A., F.C.-J., L.B., J.B.K., W.S.K., E.J., R.H.T., O.P., J.R.H., G.M.H.), Sydney; School of Medical Sciences (C.E.S., A.J.A., F.C.-J., J.B.K., W.S.K., R.H.T., G.M.H.), University of New South Wales; and ARC Centre of Excellence in Cognition and its Disorders (O.P., J.R.H.), Sydney, Australia
| | - Ciara V McGinley
- From the Discipline of Pathology (S.L.F., D.R.C., A.S., C.V.M., J.J.K.), Central Clinical School (J.B.K., W.S.K., E.J., R.H.T., J.R.H., G.M.H.), Faculty of Medicine and Health, Brain and Mind Centre (J.B.K., W.S.K., E.J., R.H.T., O.P., J.R.H., G.M.H.), and School of Psychology (O.P.), The University of Sydney; Neuroscience Research Australia (H.M., C.E.S., A.B.M., A.J.A., F.C.-J., L.B., J.B.K., W.S.K., E.J., R.H.T., O.P., J.R.H., G.M.H.), Sydney; School of Medical Sciences (C.E.S., A.J.A., F.C.-J., J.B.K., W.S.K., R.H.T., G.M.H.), University of New South Wales; and ARC Centre of Excellence in Cognition and its Disorders (O.P., J.R.H.), Sydney, Australia
| | - Olivier Piguet
- From the Discipline of Pathology (S.L.F., D.R.C., A.S., C.V.M., J.J.K.), Central Clinical School (J.B.K., W.S.K., E.J., R.H.T., J.R.H., G.M.H.), Faculty of Medicine and Health, Brain and Mind Centre (J.B.K., W.S.K., E.J., R.H.T., O.P., J.R.H., G.M.H.), and School of Psychology (O.P.), The University of Sydney; Neuroscience Research Australia (H.M., C.E.S., A.B.M., A.J.A., F.C.-J., L.B., J.B.K., W.S.K., E.J., R.H.T., O.P., J.R.H., G.M.H.), Sydney; School of Medical Sciences (C.E.S., A.J.A., F.C.-J., J.B.K., W.S.K., R.H.T., G.M.H.), University of New South Wales; and ARC Centre of Excellence in Cognition and its Disorders (O.P., J.R.H.), Sydney, Australia
| | - John R Hodges
- From the Discipline of Pathology (S.L.F., D.R.C., A.S., C.V.M., J.J.K.), Central Clinical School (J.B.K., W.S.K., E.J., R.H.T., J.R.H., G.M.H.), Faculty of Medicine and Health, Brain and Mind Centre (J.B.K., W.S.K., E.J., R.H.T., O.P., J.R.H., G.M.H.), and School of Psychology (O.P.), The University of Sydney; Neuroscience Research Australia (H.M., C.E.S., A.B.M., A.J.A., F.C.-J., L.B., J.B.K., W.S.K., E.J., R.H.T., O.P., J.R.H., G.M.H.), Sydney; School of Medical Sciences (C.E.S., A.J.A., F.C.-J., J.B.K., W.S.K., R.H.T., G.M.H.), University of New South Wales; and ARC Centre of Excellence in Cognition and its Disorders (O.P., J.R.H.), Sydney, Australia
| | - Jillian J Kril
- From the Discipline of Pathology (S.L.F., D.R.C., A.S., C.V.M., J.J.K.), Central Clinical School (J.B.K., W.S.K., E.J., R.H.T., J.R.H., G.M.H.), Faculty of Medicine and Health, Brain and Mind Centre (J.B.K., W.S.K., E.J., R.H.T., O.P., J.R.H., G.M.H.), and School of Psychology (O.P.), The University of Sydney; Neuroscience Research Australia (H.M., C.E.S., A.B.M., A.J.A., F.C.-J., L.B., J.B.K., W.S.K., E.J., R.H.T., O.P., J.R.H., G.M.H.), Sydney; School of Medical Sciences (C.E.S., A.J.A., F.C.-J., J.B.K., W.S.K., R.H.T., G.M.H.), University of New South Wales; and ARC Centre of Excellence in Cognition and its Disorders (O.P., J.R.H.), Sydney, Australia
| | - Glenda M Halliday
- From the Discipline of Pathology (S.L.F., D.R.C., A.S., C.V.M., J.J.K.), Central Clinical School (J.B.K., W.S.K., E.J., R.H.T., J.R.H., G.M.H.), Faculty of Medicine and Health, Brain and Mind Centre (J.B.K., W.S.K., E.J., R.H.T., O.P., J.R.H., G.M.H.), and School of Psychology (O.P.), The University of Sydney; Neuroscience Research Australia (H.M., C.E.S., A.B.M., A.J.A., F.C.-J., L.B., J.B.K., W.S.K., E.J., R.H.T., O.P., J.R.H., G.M.H.), Sydney; School of Medical Sciences (C.E.S., A.J.A., F.C.-J., J.B.K., W.S.K., R.H.T., G.M.H.), University of New South Wales; and ARC Centre of Excellence in Cognition and its Disorders (O.P., J.R.H.), Sydney, Australia.
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