1
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Kanaya Y, Kume K, Morino H, Ohsawa R, Kurashige T, Kamada M, Torii T, Izumi Y, Maruyama H, Kawakami H. Analysis of genetic risk factors in Japanese patients with Parkinson's disease. J Hum Genet 2021; 66:957-964. [PMID: 33742109 DOI: 10.1038/s10038-021-00910-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 02/06/2021] [Accepted: 02/08/2021] [Indexed: 11/09/2022]
Abstract
Parkinson's disease (PD) is caused by a combination of genetic and environmental factors. Notably, genetic risk factors vary according to ethnicity and geographical regions, and few studies have analyzed the frequency of PD causative genes in Japanese patients. Therefore, we performed genetic analyses of Japanese patients with PD. We recruited 221 participants, including 26 patients with familial PD. Genetic risk factors were evaluated by target sequencing and gene dosage analysis. We detected the genetic risk factors in 58 cases (26.2%) and classified patients into three groups to clarify the differences in genetic risk factors by age at onset (AAO). The early-onset group (AAO < 50 years) included 18 cases (44.7%), who tended to have a larger number of genetic risk factors than the later-onset groups. Regarding the AAO for each causative gene, patients with PRKN variants were significantly younger at onset than those bearing LRRK2 variants. LRRK2 variants showed similar frequency in each AAO group. Of note, we identified two novel variants. Patients with early-onset PD have more genetic risk factors than patients with late-onset PD. In Japanese patients with PD, PRKN, and LRRK2 were the major PD-related genes. Particularly, LRRK2 was a common genetic factor in all age groups because of the presence of the Asian-specific variant such as LRRK2 p.G2385R. Accumulation of genetic and clinical data can contribute to the development of treatments for PD.
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Affiliation(s)
- Yuhei Kanaya
- Department of Epidemiology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan.,Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Kodai Kume
- Department of Epidemiology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Hiroyuki Morino
- Department of Epidemiology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan. .,Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.
| | - Ryosuke Ohsawa
- Department of Epidemiology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Takashi Kurashige
- Department of Neurology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan
| | - Masaki Kamada
- Department of Gastroenterology & Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Tsuyoshi Torii
- Department of Neurology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan
| | - Yuishin Izumi
- Department of Neurology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Hideshi Kawakami
- Department of Epidemiology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
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2
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Chelban V, Vichayanrat E, Schottlaende L, Iodice V, Houlden H. Autonomic dysfunction in genetic forms of synucleinopathies. Mov Disord 2019; 33:359-371. [PMID: 29508456 DOI: 10.1002/mds.27343] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 01/01/2018] [Accepted: 01/19/2018] [Indexed: 12/31/2022] Open
Abstract
The discovery of genetic links between alpha-synuclein and PD has opened unprecedented opportunities for research into a new group of diseases, now collectively known as synucleinopathies. Autonomic dysfunction, including cardiac sympathetic denervation, has been reported in familial forms of synucleinopathies that have Lewy bodies at the core of their pathogenesis. SNCA mutations and multiplications, LRRK2 disease with Lewy bodies as well as other common, sporadic forms of idiopathic PD, MSA, pure autonomic failure, and dementia with Lewy bodies have all been associated with dysautonomia. By contrast, in familial cases of parkinsonism without Lewy bodies, such as in PARK2, the autonomic profile remains normal throughout the course of the disease. The degeneration of the central and peripheral autonomic systems in genetic as well as sporadic forms of neurodegenerative synucleinopathies correlates with the accumulation of alpha-synuclein immunoreactive-containing inclusions. Given that dysautonomia has a significant impact on the quality of life of sufferers and autonomic symptoms are generally treatable, a prompt diagnostic testing and treatment should be provided. Moreover, new evidence suggests that autonomic dysfunction can be used as an outcome prediction factor in some forms of synucleinopathies or premotor diagnostic markers that could be used in the future to define further research avenues. In this review, we describe the autonomic dysfunction of genetic synucleinopathies in comparison to the dysautonomia of sporadic forms of alpha-synuclein accumulation and provide the reader with an up-to-date overview of the current understanding in this fast-growing field. © 2018 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Viorica Chelban
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, United Kingdom, and National Hospital for Neurology and Neurosurgery, London, United Kingdom.,Department of Neurology and Neurosurgery, Institute of Emergency Medicine, Chisinau, Republic of Moldova
| | - Ekawat Vichayanrat
- Autonomic Unit, National Hospital for Neurology and Neurosurgery, UCL NHS Trust, London, United Kingdom
| | - Lucia Schottlaende
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, United Kingdom, and National Hospital for Neurology and Neurosurgery, London, United Kingdom.,Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Valeria Iodice
- Autonomic Unit, National Hospital for Neurology and Neurosurgery, UCL NHS Trust, London, United Kingdom.,Institute of Neurology, University College London, London, United Kingdom
| | - Henry Houlden
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, United Kingdom, and National Hospital for Neurology and Neurosurgery, London, United Kingdom
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3
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Outeiro TF, Koss DJ, Erskine D, Walker L, Kurzawa-Akanbi M, Burn D, Donaghy P, Morris C, Taylor JP, Thomas A, Attems J, McKeith I. Dementia with Lewy bodies: an update and outlook. Mol Neurodegener 2019; 14:5. [PMID: 30665447 PMCID: PMC6341685 DOI: 10.1186/s13024-019-0306-8] [Citation(s) in RCA: 197] [Impact Index Per Article: 39.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 01/08/2019] [Indexed: 01/17/2023] Open
Abstract
Dementia with Lewy bodies (DLB) is an age-associated neurodegenerative disorder producing progressive cognitive decline that interferes with normal life and daily activities. Neuropathologically, DLB is characterised by the accumulation of aggregated α-synuclein protein in Lewy bodies and Lewy neurites, similar to Parkinson’s disease (PD). Extrapyramidal motor features characteristic of PD, are common in DLB patients, but are not essential for the clinical diagnosis of DLB. Since many PD patients develop dementia as disease progresses, there has been controversy about the separation of DLB from PD dementia (PDD) and consensus reports have put forward guidelines to assist clinicians in the identification and management of both syndromes. Here, we present basic concepts and definitions, based on our current understanding, that should guide the community to address open questions that will, hopefully, lead us towards improved diagnosis and novel therapeutic strategies for DLB and other synucleinopathies.
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Affiliation(s)
- Tiago Fleming Outeiro
- Institute of Neuroscience, The Medical School, Newcastle University, Framlington Place, Newcastle Upon Tyne, NE2 4HH, UK. .,Department of Experimental Neurodegeneration, Center for Nanoscale Microscopy and Molecular Physiology of the Brain, Center for Biostructural Imaging of Neurodegeneration, University Medical Center Göttingen, Göttingen, Germany. .,Max Planck Institute for Experimental Medicine, Göttingen, Germany.
| | - David J Koss
- Institute of Neuroscience, The Medical School, Newcastle University, Framlington Place, Newcastle Upon Tyne, NE2 4HH, UK
| | - Daniel Erskine
- Institute of Neuroscience, The Medical School, Newcastle University, Framlington Place, Newcastle Upon Tyne, NE2 4HH, UK
| | - Lauren Walker
- Institute of Neuroscience, The Medical School, Newcastle University, Framlington Place, Newcastle Upon Tyne, NE2 4HH, UK
| | - Marzena Kurzawa-Akanbi
- Institute of Neuroscience, The Medical School, Newcastle University, Framlington Place, Newcastle Upon Tyne, NE2 4HH, UK
| | - David Burn
- Institute of Neuroscience, The Medical School, Newcastle University, Framlington Place, Newcastle Upon Tyne, NE2 4HH, UK
| | - Paul Donaghy
- Institute of Neuroscience, The Medical School, Newcastle University, Framlington Place, Newcastle Upon Tyne, NE2 4HH, UK
| | - Christopher Morris
- Institute of Neuroscience, The Medical School, Newcastle University, Framlington Place, Newcastle Upon Tyne, NE2 4HH, UK
| | - John-Paul Taylor
- Institute of Neuroscience, The Medical School, Newcastle University, Framlington Place, Newcastle Upon Tyne, NE2 4HH, UK
| | - Alan Thomas
- Institute of Neuroscience, The Medical School, Newcastle University, Framlington Place, Newcastle Upon Tyne, NE2 4HH, UK
| | - Johannes Attems
- Institute of Neuroscience, The Medical School, Newcastle University, Framlington Place, Newcastle Upon Tyne, NE2 4HH, UK
| | - Ian McKeith
- Institute of Neuroscience, The Medical School, Newcastle University, Framlington Place, Newcastle Upon Tyne, NE2 4HH, UK.
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Picillo M, Lizarraga KJ, Friesen EL, Chau H, Zhang M, Sato C, Rooke G, Munhoz RP, Rogaeva E, Fraser PE, Kalia SK, Kalia LV. Parkinsonism due to A53E α-synuclein gene mutation: Clinical, genetic, epigenetic, and biochemical features. Mov Disord 2018; 33:1950-1955. [DOI: 10.1002/mds.27506] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 08/21/2018] [Accepted: 09/03/2018] [Indexed: 12/14/2022] Open
Affiliation(s)
- Marina Picillo
- Center for Neurodegenerative Diseases (CEMAND), Department of Medicine and Surgery; University of Salerno; Salerno Italy
- Edmond J. Safra Program in Parkinson's Disease and Morton and Gloria Shulman Movement Disorders Clinic, Division of Neurology, Department of Medicine, Toronto Western Hospital; University Health Network; Toronto Ontario Canada
- Division of Neurology, Department of Medicine; University of Toronto; Toronto Ontario Canada
| | - Karlo J. Lizarraga
- Edmond J. Safra Program in Parkinson's Disease and Morton and Gloria Shulman Movement Disorders Clinic, Division of Neurology, Department of Medicine, Toronto Western Hospital; University Health Network; Toronto Ontario Canada
- Division of Neurology, Department of Medicine; University of Toronto; Toronto Ontario Canada
| | - Erik L. Friesen
- Krembil Research Institute, Toronto Western Hospital; University Health Network; Toronto Ontario Canada
| | - Hien Chau
- Krembil Research Institute, Toronto Western Hospital; University Health Network; Toronto Ontario Canada
| | - Ming Zhang
- Tanz Centre for Research in Neurodegenerative Diseases; University of Toronto; Toronto Ontario Canada
| | - Christine Sato
- Tanz Centre for Research in Neurodegenerative Diseases; University of Toronto; Toronto Ontario Canada
| | - Grace Rooke
- Tanz Centre for Research in Neurodegenerative Diseases; University of Toronto; Toronto Ontario Canada
| | - Renato P. Munhoz
- Edmond J. Safra Program in Parkinson's Disease and Morton and Gloria Shulman Movement Disorders Clinic, Division of Neurology, Department of Medicine, Toronto Western Hospital; University Health Network; Toronto Ontario Canada
- Division of Neurology, Department of Medicine; University of Toronto; Toronto Ontario Canada
| | - Ekaterina Rogaeva
- Division of Neurology, Department of Medicine; University of Toronto; Toronto Ontario Canada
- Tanz Centre for Research in Neurodegenerative Diseases; University of Toronto; Toronto Ontario Canada
| | - Paul E. Fraser
- Tanz Centre for Research in Neurodegenerative Diseases; University of Toronto; Toronto Ontario Canada
- Department of Medical Biophysics; University of Toronto; Toronto Ontario Canada
| | - Suneil K. Kalia
- Krembil Research Institute, Toronto Western Hospital; University Health Network; Toronto Ontario Canada
- Division of Neurosurgery, Department of Surgery; University of Toronto; Toronto Ontario Canada
| | - Lorraine V. Kalia
- Edmond J. Safra Program in Parkinson's Disease and Morton and Gloria Shulman Movement Disorders Clinic, Division of Neurology, Department of Medicine, Toronto Western Hospital; University Health Network; Toronto Ontario Canada
- Division of Neurology, Department of Medicine; University of Toronto; Toronto Ontario Canada
- Krembil Research Institute, Toronto Western Hospital; University Health Network; Toronto Ontario Canada
- Tanz Centre for Research in Neurodegenerative Diseases; University of Toronto; Toronto Ontario Canada
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5
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Orme T, Guerreiro R, Bras J. The Genetics of Dementia with Lewy Bodies: Current Understanding and Future Directions. Curr Neurol Neurosci Rep 2018; 18:67. [PMID: 30097731 PMCID: PMC6097049 DOI: 10.1007/s11910-018-0874-y] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE OF REVIEW Dementia with Lewy bodies (DLB) is a neurodegenerative disease that can be clinically and pathologically similar to Parkinson's disease (PD) and Alzheimer's disease (AD). Current understanding of DLB genetics is insufficient and has been limited by sample size and difficulty in diagnosis. The first genome-wide association study (GWAS) in DLB was performed in 2017; a time at which the post-GWAS era has been reached in many diseases. RECENT FINDINGS DLB shares risk loci with AD, in the APOE E4 allele, and with PD, in variation at GBA and SNCA. Interestingly, the GWAS suggested that DLB may also have genetic risk factors that are distinct from those in AD and PD. Although off to a slow start, recent studies have reinvigorated the field of DLB genetics and these results enable us to start to have a more complete understanding of the genetic architecture of this disease.
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Affiliation(s)
- Tatiana Orme
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
- UK Dementia Research Institute at UCL, Institute of Neurology, Wing 1.2, The Cruciform Building, Gower Street, London, WC1E 6BT, UK
| | - Rita Guerreiro
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
- UK Dementia Research Institute at UCL, Institute of Neurology, Wing 1.2, The Cruciform Building, Gower Street, London, WC1E 6BT, UK
- Department of Medical Sciences and Institute of Biomedicine, iBiMED, University of Aveiro, 3810-193, Aveiro, Portugal
| | - Jose Bras
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK.
- UK Dementia Research Institute at UCL, Institute of Neurology, Wing 1.2, The Cruciform Building, Gower Street, London, WC1E 6BT, UK.
- Department of Medical Sciences and Institute of Biomedicine, iBiMED, University of Aveiro, 3810-193, Aveiro, Portugal.
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6
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An update on the genetics of dementia with Lewy bodies. Parkinsonism Relat Disord 2017; 43:1-8. [DOI: 10.1016/j.parkreldis.2017.07.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 07/12/2017] [Indexed: 02/06/2023]
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8
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Geiger JT, Ding J, Crain B, Pletnikova O, Letson C, Dawson TM, Rosenthal LS, Pantelyat A, Gibbs JR, Albert MS, Hernandez DG, Hillis AE, Stone DJ, Singleton AB, Hardy JA, Troncoso JC, Scholz SW. Next-generation sequencing reveals substantial genetic contribution to dementia with Lewy bodies. Neurobiol Dis 2016; 94:55-62. [PMID: 27312774 DOI: 10.1016/j.nbd.2016.06.004] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 06/08/2016] [Accepted: 06/11/2016] [Indexed: 11/15/2022] Open
Abstract
Dementia with Lewy bodies (DLB) is the second most common neurodegenerative dementia after Alzheimer's disease. Although an increasing number of genetic factors have been connected to this debilitating condition, the proportion of cases that can be attributed to distinct genetic defects is unknown. To provide a comprehensive analysis of the frequency and spectrum of pathogenic missense mutations and coding risk variants in nine genes previously implicated in DLB, we performed exome sequencing in 111 pathologically confirmed DLB patients. All patients were Caucasian individuals from North America. Allele frequencies of identified missense mutations were compared to 222 control exomes. Remarkably, ~25% of cases were found to carry a pathogenic mutation or risk variant in APP, GBA or PSEN1, highlighting that genetic defects play a central role in the pathogenesis of this common neurodegenerative disorder. In total, 13% of our cohort carried a pathogenic mutation in GBA, 10% of cases carried a risk variant or mutation in PSEN1, and 2% were found to carry an APP mutation. The APOE ε4 risk allele was significantly overrepresented in DLB patients (p-value <0.001). Our results conclusively show that mutations in GBA, PSEN1, and APP are common in DLB and consideration should be given to offer genetic testing to patients diagnosed with Lewy body dementia.
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Affiliation(s)
- Joshua T Geiger
- Neurodegenerative Diseases Research Unit, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Jinhui Ding
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Barbara Crain
- Department of Pathology (Neuropathology), Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Olga Pletnikova
- Department of Pathology (Neuropathology), Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Christopher Letson
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Ted M Dawson
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Solomon H. Synder Department of Neuroscience, Johns Hopkins University, Baltimore, MD, USA; Department of Pharmacology and Molecular Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Neuroregeneration Program, Institute of Cell Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Liana S Rosenthal
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alexander Pantelyat
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - J Raphael Gibbs
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Marilyn S Albert
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Dena G Hernandez
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Argye E Hillis
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - David J Stone
- Genetics and Pharmacogenomics, Merck Research Laboratories, West Point, PA, USA
| | - Andrew B Singleton
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | | | - John A Hardy
- Department of Molecular Neuroscience, University College London, London, UK
| | - Juan C Troncoso
- Department of Pathology (Neuropathology), Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sonja W Scholz
- Neurodegenerative Diseases Research Unit, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA; Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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9
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Scholz SW, Bras J. Genetics Underlying Atypical Parkinsonism and Related Neurodegenerative Disorders. Int J Mol Sci 2015; 16:24629-55. [PMID: 26501269 PMCID: PMC4632769 DOI: 10.3390/ijms161024629] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 10/01/2015] [Accepted: 10/09/2015] [Indexed: 12/14/2022] Open
Abstract
Atypical parkinsonism syndromes, such as dementia with Lewy bodies, multiple system atrophy, progressive supranuclear palsy and corticobasal degeneration, are neurodegenerative diseases with complex clinical and pathological features. Heterogeneity in clinical presentations, possible secondary determinants as well as mimic syndromes pose a major challenge to accurately diagnose patients suffering from these devastating conditions. Over the last two decades, significant advancements in genomic technologies have provided us with increasing insights into the molecular pathogenesis of atypical parkinsonism and their intriguing relationships to related neurodegenerative diseases, fueling new hopes to incorporate molecular knowledge into our diagnostic, prognostic and therapeutic approaches towards managing these conditions. In this review article, we summarize the current understanding of genetic mechanisms implicated in atypical parkinsonism syndromes. We further highlight mimic syndromes relevant to differential considerations and possible future directions.
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Affiliation(s)
- Sonja W Scholz
- Neurodegenerative Diseases Research Unit, Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, National Institutes of Health, 35 Convent Drive, Bethesda, MD 20892, USA.
- Department of Neurology, Johns Hopkins University School of Medicine, 1800 Orleans Street, Baltimore, MD 21287, USA.
| | - Jose Bras
- Department of Molecular Neuroscience, University College London, Institute of Neurology, Queen Square House, London WC1N 3BG, UK.
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10
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Konno T, Ross OA, Puschmann A, Dickson DW, Wszolek ZK. Autosomal dominant Parkinson's disease caused by SNCA duplications. Parkinsonism Relat Disord 2015; 22 Suppl 1:S1-6. [PMID: 26350119 DOI: 10.1016/j.parkreldis.2015.09.007] [Citation(s) in RCA: 132] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 09/02/2015] [Indexed: 10/23/2022]
Abstract
The discovery in 1997 that mutations in the SNCA gene cause Parkinson's disease (PD) greatly advanced our understanding of this illness. There are pathogenic missense mutations and multiplication mutations in SNCA. Thus, not only a mutant protein, but also an increased dose of wild-type protein can produce autosomal dominant parkinsonism. We review the literature on SNCA duplications and focus on pathologically-confirmed cases. We also report a newly-identified American family with SNCA duplication whose proband was autopsied. We found that over half of the reported cases with SNCA duplication had early-onset parkinsonism and non-motor features, such as dysautonomia, rapid eye movement sleep behavior disorder (RBD), hallucinations (usually visual) and cognitive deficits leading to dementia. Only a few cases have presented with typical features of PD. Our case presented with depression and RBD that preceded parkinsonism, and dysautonomia that led to an initial diagnosis of multiple system atrophy. Dementia and visual hallucinations followed. Our patient and the other reported cases with SNCA duplications had widespread cortical Lewy pathology. Neuronal loss in the hippocampal cornu ammonis 2/3 regions were seen in about half of the autopsied SNCA duplication cases. Similar pathology was also observed in SNCA missense mutation and triplication carriers.
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Affiliation(s)
- Takuya Konno
- Department of Neurology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA
| | - Owen A Ross
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA
| | - Andreas Puschmann
- Lund University, Department of Clinical Sciences, Lund, Neurology, Getingevägen 4, 22185 Lund, Sweden
| | - Dennis W Dickson
- Department of Neuropathology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA
| | - Zbigniew K Wszolek
- Department of Neurology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA.
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11
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12
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Tsuboi Y. Environmental-genetic interactions in the pathogenesis of Parkinson's disease. Exp Neurobiol 2012; 21:123-8. [PMID: 23055790 PMCID: PMC3454809 DOI: 10.5607/en.2012.21.3.123] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2012] [Accepted: 07/04/2012] [Indexed: 01/30/2023] Open
Abstract
To date, numerous case-control studies have shown the complexity of the pathogenesis of Parkinson's disease (PD). In terms of genetic factors, several susceptibility genes are known to contribute to the development of PD, including α-synuclein (SNCA), leucine-rich repeat kinase 2 (LRRK2), and glucocerebrosidase (GBA). In addition, numerous recent epidemiological studies have shown that several environmental factors are either risk factors for PD or protective factors against PD. Risk factors identified include herbicides and pesticides (e.g., paraquat, rotenone, and maneb), metals (e.g., manganese and lead), head trauma, and well water. In contrast, smoking and coffee/caffeine consumption are known to be protective against PD. A recent finding in this field is that environmental-genetic interactions contribute more to the pathogenesis of PD than do genetic factors or environmental factors alone. In this review, I will discuss how these interactions promote the development of PD.
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Affiliation(s)
- Yoshio Tsuboi
- Department of Neurology, School of Medicine, Fukuoka University, Fukuoka 814-0180, Japan
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13
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Kurz MW, Schlitter AM, Larsen JP, Ballard C, Aarsland D. Familial occurrence of dementia and parkinsonism: a systematic review. Dement Geriatr Cogn Disord 2007; 22:288-95. [PMID: 16921239 DOI: 10.1159/000095159] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/09/2006] [Indexed: 01/14/2023] Open
Abstract
Parkinson's disease with dementia (PDD) and dementia with Lewy bodies (DLB) are common clinical dementias characterized neuropathologically by the presence of cortical Lewy body pathology and with distinct clinical and neurobiological similarities. Importantly, genetic factors seem to play a key role in the pathogenesis of Parkinson's disease. In the current article, we examine the evidence for a genetic component to DLB and PDD by reviewing studies of familial PDD and DLB as well as familial coincidental PDD and DLB, and report the genes involved. There is a convincing genetic overlap between both syndromes, suggesting that they share a common etiological factor.
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14
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Michel B, Becker H, Pellissier JF. Demenza a corpi di Lewy. Neurologia 2007. [DOI: 10.1016/s1634-7072(07)70550-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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15
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Boeve BF. Clinical, diagnostic, genetic and management issues in dementia with Lewy bodies. Clin Sci (Lond) 2005; 109:343-54. [PMID: 16171458 DOI: 10.1042/cs20050098] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
DLB (dementia with Lewy bodies) is a syndrome associated with underlying LBD (Lewy body disease), with manifestations in the cognitive, neuropsychiatric, motor, sleep and autonomic domains. The variable symptomatology and complex array of neuronal involvement and neurotransmitter deficiencies make the diagnosis and management of patients with DLB challenging. The genetic underpinnings of DLB have only recently begun to unfold. In this review, the clinical features, diagnostic criteria, genetics and treatment issues relating to DLB will be discussed, in which a comprehensive approach to the diagnosis and management is emphasized.
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Affiliation(s)
- Bradley F Boeve
- Division of Behavioral Neurology, Department of Neurology, Mayo Clinic, Rochester, MN 559505, U.S.A.
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16
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Ishikawa A, Piao YS, Miyashita A, Kuwano R, Onodera O, Ohtake H, Suzuki M, Nishizawa M, Takahashi H. A mutant PSEN1 causes dementia with Lewy bodies and variant Alzheimer's disease. Ann Neurol 2005; 57:429-34. [PMID: 15732120 DOI: 10.1002/ana.20393] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
We report early-onset parkinsonism and dementia of 18 years' duration in a 52-year-old man whose grandfather and father had suffered from a similar neurological disease. In this patient, we found neuronal loss in various brain regions including the substantia nigra and cerebral cortex, Lewy bodies, cotton wool plaques, corticospinal tract degeneration, cerebral amyloid angiopathy, and a novel three-base pair deletion in exon 12 of the presenilin-1 (PSEN1) gene. We considered that the mutant PSEN1 might play an important role in the pathogenetic process of both aggregation of alpha-synuclein into Lewy bodies and deposition of beta-amyloid into cotton wool plaques.
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Affiliation(s)
- Atsushi Ishikawa
- Department of Neurology, Nishi-Ojiya National Hospital, Ojiya, Japan.
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Zarranz JJ, Fernández-Bedoya A, Lambarri I, Gómez-Esteban JC, Lezcano E, Zamacona J, Madoz P. Abnormal sleep architecture is an early feature in the E46K familial synucleinopathy. Mov Disord 2005; 20:1310-5. [PMID: 16001411 DOI: 10.1002/mds.20581] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
We examined 7 patients from a family harboring a novel mutation in the alpha-synuclein gene (E46K) that segregated with a phenotype of parkinsonism and dementia with Lewy bodies. An abnormal restless sleep was the presenting symptom in 2 of them. Polysomnographic (PSG) studies were performed in 4 of the 7 patients and in 2 asymptomatic carriers of the mutation. A severe loss of both rapid eye movement (REM) and non-REM sleep was observed in 2 patients complaining of insomnia and in a third parkinsonian member of the family who did not complain of trouble with sleeping. Another parkinsonian family member had a mild disorganization of the sleep architecture. The 2 asymptomatic carriers also had minor changes in the PSG findings. Episodes of bizarre behavior at night were reported historically in the 2 symptomatic patients, but we did not observed the behaviors during the PSG studies. REM sleep behavior disorder could not be recorded in any case. Our findings expand the spectrum of sleep disorders reported in synucleinopathies whether sporadic or familial.
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Affiliation(s)
- Juan J Zarranz
- Neurology Service, Hospital of Cruces, Department of Neurosciences, University of the Basque Country, Baracaldo, Vizcaya, Spain.
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Harding AJ, Das A, Kril JJ, Brooks WS, Duffy D, Halliday GM. Identification of families with cortical Lewy body disease. Am J Med Genet B Neuropsychiatr Genet 2004; 128B:118-22. [PMID: 15211643 DOI: 10.1002/ajmg.b.30014] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Until recently, cortical Lewy body disease (CLB) was considered essentially the same as dementia with Lewy bodies (DLB). It is now known patients with Parkinson's disease (PD) with a later-onset dementia (PD-dementia) have the same pattern and extent of cortical Lewy body pathology. Inheritance patterns of CLB have not been evaluated previously. To identify genetic influence on CLB, all cases with this pathology need to be considered. We selected 180 cases meeting clinical and/or pathological criteria for DLB or PD (+/-dementia) from two patient groups: a PD and PD-dementia brain donor program, and a case-control study of Alzheimer's disease (AD). Cases meeting NINCDS-ADRDA criteria for probable AD were excluded and non-demented PD cases used as a comparison group. A detailed family history was taken analyzing onset and progression of dementia and PD phenotypes and a family tree constructed. The frequency of a positive family history of dementia and/or PD and risk of developing CLB in relatives was calculated. Fifty-five percent of dementia and 52% of PD cohorts did not have relatives with clinical disease. There was no increased frequency of familial disease in the CLB cohort compared with PD. However, in half the CLB families, rather than a dominant dementia, the clinical presentation varied (dementia and/or PD). Unlike PD, there was an increased risk of dementia if CLB was present in a parent ( approximately 20% risk) compared with another family member ( approximately 5% risk), suggesting CLB is more likely than PD to occur in a pattern consistent with autosomal dominant inheritance.
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Affiliation(s)
- Antony J Harding
- Prince of Wales Medical Research Institute, Barker Street, Randwick, Sydney, NSW 2031, Australia.
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19
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Zarranz JJ, Alegre J, Gómez-Esteban JC, Lezcano E, Ros R, Ampuero I, Vidal L, Hoenicka J, Rodriguez O, Atarés B, Llorens V, Gomez Tortosa E, del Ser T, Muñoz DG, de Yebenes JG. The new mutation, E46K, of alpha-synuclein causes Parkinson and Lewy body dementia. Ann Neurol 2004; 55:164-73. [PMID: 14755719 DOI: 10.1002/ana.10795] [Citation(s) in RCA: 2018] [Impact Index Per Article: 100.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Familial parkinsonism and dementia with cortical and subcortical Lewy bodies is uncommon, and no genetic defect has been reported in the previously described sibships. We present a Spanish family with autosomal dominant parkinsonism, dementia, and visual hallucinations of variable severity. The postmortem examination showed atrophy of the substantia nigra, lack of Alzheimer pathology, and numerous Lewy bodies which were immunoreactive to alpha-synuclein and ubiquitin in cortical and subcortical areas. Sequencing of the alpha-synuclein gene showed a novel, nonconservative E46K mutation in heterozygosis. The E46K mutation was present in all affected family members and in three young asymptomatic subjects, but it was absent in healthy and pathological controls. The novel mutation, that substitutes a dicarboxylic amino acid, glutamic acid, with a basic amino acid such as lysine in a much conserved area of the protein, is likely to produce severe disturbance of protein function. Our data show that, in addition to the previously described hereditary alpha-synucleinopathies, dementia with Lewy bodies is related to mutation of alpha-synuclein.
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Affiliation(s)
- Juan J Zarranz
- Department of Neurology, de Cruces Hospital, Departament of Neuroscience, University del País Vasco, Baracaldo, Vizcaya, Spain.
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Trembath Y, Rosenberg C, Ervin JF, Schmechel DE, Gaskell P, Pericak-Vance M, Vance J, Hulette CM. Lewy body pathology is a frequent co-pathology in familial Alzheimer's disease. Acta Neuropathol 2003; 105:484-8. [PMID: 12677449 DOI: 10.1007/s00401-003-0670-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2002] [Revised: 12/16/2002] [Accepted: 12/16/2002] [Indexed: 10/25/2022]
Abstract
Our institution is currently engaged in ongoing genetic studies of familial Alzheimer's disease (AD), which include clinical ascertainment and brain autopsy of both affected and non-affected family members. Here we describe the analysis of 22 AD families, each with at least one family member with a postmortem diagnosis of dementia with Lewy bodies (DLB). For this study, 47 brains were examined according to NINCDS-Reagan Institute criteria for the diagnosis of AD. Lewy body pathology was evaluated with alpha-synuclein immunohistochemistry. Four families, with either one or two autopsies showing Lewy body pathology, demonstrated linkage to 12p. Five families had two or more autopsies with Lewy body pathology, but their linkage status was unknown. The remaining 13 families had one autopsy demonstrating Lewy bodies. These findings suggest that at least one pathological form of DLB may be familial. In some families, the pathological phenotype is identical in all examined affected family members; but in others, there may be several pathologies that coexist. Careful neuropathological examination of affected family members may prove critical for future genetic analysis of AD and DLB.
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Affiliation(s)
- Yuri Trembath
- Department of Pathology, Section of Neuropathology, Duke University Medical Center, Box 3712, Durham, NC 27710, USA
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22
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Abstract
Lewy body disease includes clinically and pathologically defined disorders in which Lewy bodies occur in the nervous system. In recent years, the molecular features of these disorders have been emerging. Several genetic loci have been identified in association with familial Lewy body disease; however, the genetic risks underlying most cases of familial Lewy body disease remain to be discovered. The fact that Lewy bodies stain strongly with antibodies to asynuclein and that mutations in the alpha-synuclein gene lead to syndromes in which parkinsonism and dementia occur gives us important clues regarding the biologic processes leading to disease. Pursuit of additional mendelian causes of familial Lewy body disease and study of the factors contributing to the complex phenotypes associated with Lewy body disorders will elucidate underlying disease pathways and, thus, possible targets for therapeutic intervention.
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Affiliation(s)
- Katrina Gwinn-Hardy
- Division of Intramural Research, Neurogenetics Laboratories, National Institute of Neurological Disease and Stroke, National Institutes of Health, Bethesda, Maryland 20892, USA
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Bonner LT, Tsuang DW, Cherrier MM, Eugenio CJ, Du JQ, Steinbart EJ, Limprasert P, La Spada AR, Seltzer B, Bird TD, Leverenz JB. Familial dementia with Lewy bodies with an atypical clinical presentation. J Geriatr Psychiatry Neurol 2003; 16:59-64. [PMID: 12641375 PMCID: PMC1482838 DOI: 10.1177/0891988702250585] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The authors report a case of a 64-year-old male with Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) pathology at autopsy who did not manifest the core symptoms of DLB until very late in his clinical course. His initial presentation of early executive and language dysfunction suggested a cortical dementia similar to frontotemporal lobar degeneration (FTLD). Core symptoms of DLB including dementia, hallucination, and parkinsonian symptoms were not apparent until late in the course of his illness. Autopsy revealed both brainstem and cortical Lewy bodies and AD pathology. Family history revealed 7 relatives with a history of dementia including 4 with possible or probable DLB. This case is unique because of the FTLD-like presentation, positive family history of dementia, and autopsy confirmation of DLB.
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Affiliation(s)
- Lauren T. Bonner
- From the Department of Veterans Affairs Northwest Network Mental Illness Research, Education, and Clinical Center (MIRECC) (Drs. Bonner, Tsuang, Eugenio, Du, and Leverenz); Parkinson’s Disease Research, Education, and Clinical Center (Dr. Leverenz); and Geriatric Research, Education and Clinical Centers (Dr. Bird and Ms. Steinbart), University of Washington, Seattle; Departments of Laboratory Medicine (Drs. Limprasert and La Spada), Neurology (Drs. La Spada, Bird, and Leverenz), Psychiatry and Behavioral Sciences (Drs. Bonner, Tsuang, Cherrier, and Leverenz), and Medicine (Medical Genetics) (Drs. Bird and La Spada), University of Washington, Seattle; and Tulane University School of Medicine, Department of Psychiatry and Neurology and the Department of Veterans Affairs South Central MIRECC (Dr. Seltzer), New Orleans, Louisiana
| | - Debby W. Tsuang
- From the Department of Veterans Affairs Northwest Network Mental Illness Research, Education, and Clinical Center (MIRECC) (Drs. Bonner, Tsuang, Eugenio, Du, and Leverenz); Parkinson’s Disease Research, Education, and Clinical Center (Dr. Leverenz); and Geriatric Research, Education and Clinical Centers (Dr. Bird and Ms. Steinbart), University of Washington, Seattle; Departments of Laboratory Medicine (Drs. Limprasert and La Spada), Neurology (Drs. La Spada, Bird, and Leverenz), Psychiatry and Behavioral Sciences (Drs. Bonner, Tsuang, Cherrier, and Leverenz), and Medicine (Medical Genetics) (Drs. Bird and La Spada), University of Washington, Seattle; and Tulane University School of Medicine, Department of Psychiatry and Neurology and the Department of Veterans Affairs South Central MIRECC (Dr. Seltzer), New Orleans, Louisiana
| | - Monique M. Cherrier
- From the Department of Veterans Affairs Northwest Network Mental Illness Research, Education, and Clinical Center (MIRECC) (Drs. Bonner, Tsuang, Eugenio, Du, and Leverenz); Parkinson’s Disease Research, Education, and Clinical Center (Dr. Leverenz); and Geriatric Research, Education and Clinical Centers (Dr. Bird and Ms. Steinbart), University of Washington, Seattle; Departments of Laboratory Medicine (Drs. Limprasert and La Spada), Neurology (Drs. La Spada, Bird, and Leverenz), Psychiatry and Behavioral Sciences (Drs. Bonner, Tsuang, Cherrier, and Leverenz), and Medicine (Medical Genetics) (Drs. Bird and La Spada), University of Washington, Seattle; and Tulane University School of Medicine, Department of Psychiatry and Neurology and the Department of Veterans Affairs South Central MIRECC (Dr. Seltzer), New Orleans, Louisiana
| | - Charisma J. Eugenio
- From the Department of Veterans Affairs Northwest Network Mental Illness Research, Education, and Clinical Center (MIRECC) (Drs. Bonner, Tsuang, Eugenio, Du, and Leverenz); Parkinson’s Disease Research, Education, and Clinical Center (Dr. Leverenz); and Geriatric Research, Education and Clinical Centers (Dr. Bird and Ms. Steinbart), University of Washington, Seattle; Departments of Laboratory Medicine (Drs. Limprasert and La Spada), Neurology (Drs. La Spada, Bird, and Leverenz), Psychiatry and Behavioral Sciences (Drs. Bonner, Tsuang, Cherrier, and Leverenz), and Medicine (Medical Genetics) (Drs. Bird and La Spada), University of Washington, Seattle; and Tulane University School of Medicine, Department of Psychiatry and Neurology and the Department of Veterans Affairs South Central MIRECC (Dr. Seltzer), New Orleans, Louisiana
| | - Jennifer Q. Du
- From the Department of Veterans Affairs Northwest Network Mental Illness Research, Education, and Clinical Center (MIRECC) (Drs. Bonner, Tsuang, Eugenio, Du, and Leverenz); Parkinson’s Disease Research, Education, and Clinical Center (Dr. Leverenz); and Geriatric Research, Education and Clinical Centers (Dr. Bird and Ms. Steinbart), University of Washington, Seattle; Departments of Laboratory Medicine (Drs. Limprasert and La Spada), Neurology (Drs. La Spada, Bird, and Leverenz), Psychiatry and Behavioral Sciences (Drs. Bonner, Tsuang, Cherrier, and Leverenz), and Medicine (Medical Genetics) (Drs. Bird and La Spada), University of Washington, Seattle; and Tulane University School of Medicine, Department of Psychiatry and Neurology and the Department of Veterans Affairs South Central MIRECC (Dr. Seltzer), New Orleans, Louisiana
| | - Ellen J. Steinbart
- From the Department of Veterans Affairs Northwest Network Mental Illness Research, Education, and Clinical Center (MIRECC) (Drs. Bonner, Tsuang, Eugenio, Du, and Leverenz); Parkinson’s Disease Research, Education, and Clinical Center (Dr. Leverenz); and Geriatric Research, Education and Clinical Centers (Dr. Bird and Ms. Steinbart), University of Washington, Seattle; Departments of Laboratory Medicine (Drs. Limprasert and La Spada), Neurology (Drs. La Spada, Bird, and Leverenz), Psychiatry and Behavioral Sciences (Drs. Bonner, Tsuang, Cherrier, and Leverenz), and Medicine (Medical Genetics) (Drs. Bird and La Spada), University of Washington, Seattle; and Tulane University School of Medicine, Department of Psychiatry and Neurology and the Department of Veterans Affairs South Central MIRECC (Dr. Seltzer), New Orleans, Louisiana
| | - Pornprot Limprasert
- From the Department of Veterans Affairs Northwest Network Mental Illness Research, Education, and Clinical Center (MIRECC) (Drs. Bonner, Tsuang, Eugenio, Du, and Leverenz); Parkinson’s Disease Research, Education, and Clinical Center (Dr. Leverenz); and Geriatric Research, Education and Clinical Centers (Dr. Bird and Ms. Steinbart), University of Washington, Seattle; Departments of Laboratory Medicine (Drs. Limprasert and La Spada), Neurology (Drs. La Spada, Bird, and Leverenz), Psychiatry and Behavioral Sciences (Drs. Bonner, Tsuang, Cherrier, and Leverenz), and Medicine (Medical Genetics) (Drs. Bird and La Spada), University of Washington, Seattle; and Tulane University School of Medicine, Department of Psychiatry and Neurology and the Department of Veterans Affairs South Central MIRECC (Dr. Seltzer), New Orleans, Louisiana
| | - Albert R. La Spada
- From the Department of Veterans Affairs Northwest Network Mental Illness Research, Education, and Clinical Center (MIRECC) (Drs. Bonner, Tsuang, Eugenio, Du, and Leverenz); Parkinson’s Disease Research, Education, and Clinical Center (Dr. Leverenz); and Geriatric Research, Education and Clinical Centers (Dr. Bird and Ms. Steinbart), University of Washington, Seattle; Departments of Laboratory Medicine (Drs. Limprasert and La Spada), Neurology (Drs. La Spada, Bird, and Leverenz), Psychiatry and Behavioral Sciences (Drs. Bonner, Tsuang, Cherrier, and Leverenz), and Medicine (Medical Genetics) (Drs. Bird and La Spada), University of Washington, Seattle; and Tulane University School of Medicine, Department of Psychiatry and Neurology and the Department of Veterans Affairs South Central MIRECC (Dr. Seltzer), New Orleans, Louisiana
| | - Benjamin Seltzer
- From the Department of Veterans Affairs Northwest Network Mental Illness Research, Education, and Clinical Center (MIRECC) (Drs. Bonner, Tsuang, Eugenio, Du, and Leverenz); Parkinson’s Disease Research, Education, and Clinical Center (Dr. Leverenz); and Geriatric Research, Education and Clinical Centers (Dr. Bird and Ms. Steinbart), University of Washington, Seattle; Departments of Laboratory Medicine (Drs. Limprasert and La Spada), Neurology (Drs. La Spada, Bird, and Leverenz), Psychiatry and Behavioral Sciences (Drs. Bonner, Tsuang, Cherrier, and Leverenz), and Medicine (Medical Genetics) (Drs. Bird and La Spada), University of Washington, Seattle; and Tulane University School of Medicine, Department of Psychiatry and Neurology and the Department of Veterans Affairs South Central MIRECC (Dr. Seltzer), New Orleans, Louisiana
| | - Thomas D. Bird
- From the Department of Veterans Affairs Northwest Network Mental Illness Research, Education, and Clinical Center (MIRECC) (Drs. Bonner, Tsuang, Eugenio, Du, and Leverenz); Parkinson’s Disease Research, Education, and Clinical Center (Dr. Leverenz); and Geriatric Research, Education and Clinical Centers (Dr. Bird and Ms. Steinbart), University of Washington, Seattle; Departments of Laboratory Medicine (Drs. Limprasert and La Spada), Neurology (Drs. La Spada, Bird, and Leverenz), Psychiatry and Behavioral Sciences (Drs. Bonner, Tsuang, Cherrier, and Leverenz), and Medicine (Medical Genetics) (Drs. Bird and La Spada), University of Washington, Seattle; and Tulane University School of Medicine, Department of Psychiatry and Neurology and the Department of Veterans Affairs South Central MIRECC (Dr. Seltzer), New Orleans, Louisiana
| | - James B. Leverenz
- From the Department of Veterans Affairs Northwest Network Mental Illness Research, Education, and Clinical Center (MIRECC) (Drs. Bonner, Tsuang, Eugenio, Du, and Leverenz); Parkinson’s Disease Research, Education, and Clinical Center (Dr. Leverenz); and Geriatric Research, Education and Clinical Centers (Dr. Bird and Ms. Steinbart), University of Washington, Seattle; Departments of Laboratory Medicine (Drs. Limprasert and La Spada), Neurology (Drs. La Spada, Bird, and Leverenz), Psychiatry and Behavioral Sciences (Drs. Bonner, Tsuang, Cherrier, and Leverenz), and Medicine (Medical Genetics) (Drs. Bird and La Spada), University of Washington, Seattle; and Tulane University School of Medicine, Department of Psychiatry and Neurology and the Department of Veterans Affairs South Central MIRECC (Dr. Seltzer), New Orleans, Louisiana
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Ballard C, Walker M, O'Brien J, Rowan E, McKeith I. The characterisation and impact of 'fluctuating' cognition in dementia with Lewy bodies and Alzheimer's disease. Int J Geriatr Psychiatry 2001; 16:494-8. [PMID: 11376465 DOI: 10.1002/gps.368] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Case reports and clinical observations suggest that fluctuating cognition (FC) is common in all the major dementias, particularly dementia with Lewy bodies (DLB) where it is one of three core clinical diagnostic features. The purpose of this study was to characterise FC and determine its impact upon activities of daily living. METHODS Forty matched subjects (15 DLB, 15 AD, 10 elderly controls) were assessed using the activities of daily living scale (ADLD), the cognitive drug research (CDR) computerised neuropsychological test battery and a semi-standardised assessment of FC. The CDR battery was completed three times across a 1-week period, to evaluate variability in attention, visuospatial ability, working memory and delayed recall. RESULTS There was a strong positive correlation between clinical FC scores and total mean ADLD. Measures of cognitive variability also demonstrated strong significant correlations with independent clinical severity ratings of FC across several cognitive domains. These associations were most powerful between attentional measures and clinical FC ratings. CONCLUSIONS Although attention is the cognitive domain which fluctuates most markedly, other cognitive domains are also affected. FC also has a significant independent impact on activities of daily living.
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Affiliation(s)
- C Ballard
- Institute of Health for the Elderly, Newcastle General Hospital, Newcastle upon Tyne, UK.
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25
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Ransmayr G. Dementia with Lewy bodies: prevalence, clinical spectrum and natural history. JOURNAL OF NEURAL TRANSMISSION. SUPPLEMENTUM 2001:303-14. [PMID: 11205149 DOI: 10.1007/978-3-7091-6301-6_21] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
The article summarises history, terminology, the clinical and neuropathological diagnostic criteria, neurochemical and genetic findings, sensitivity and specificity of the clinical diagnostic criteria, prevalence, demographical data and nosology, differential diagnosis, and therapy of dementia with Lewy bodies (DLB). DLB shares clinical symptoms of Parkinson's disease and dementia of the Alzheimer-type (DAT). However, DLB is also different to PD and DAT (less tremor and asymmetry of the motor symptoms, more falls, and less favourable response to L-Dopa than PD; in contrast to DAT marked cognitive fluctuations and phases of reduced alertness, hallucinations and delirium). There are genetic similarities to DAT and PD in terms of common genetic risk factors. A genetic cause of the disease has so far not been detected. Whether or not DLB is a disease entity or an association of diseases (Lewy body disease and DAT) has so far not been elucidated. Clinical distinction from DAT and PD has clinical importance because of different therapeutic and prognostic implications. Studies are needed to standardize the treatment of motor, cognitive, psychiatric and vegetative symptoms.
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Affiliation(s)
- G Ransmayr
- Department of Neurology, University of Innsbruck, Austria
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26
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Okamura N, Arai H, Higuchi M, Tashiro M, Matsui T, Hu XS, Takeda A, Itoh M, Sasaki H. [18F]FDG-PET study in dementia with Lewy bodies and Alzheimer's disease. Prog Neuropsychopharmacol Biol Psychiatry 2001; 25:447-56. [PMID: 11294488 DOI: 10.1016/s0278-5846(01)80005-1] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
1. The authors report two siblings with dementia with Lewy bodies (DLB). Both the older brother and the younger sister underwent positron emission tomography (PET) studies with [18F]-2-fluoro-deoxy-D-glucose (FDG) during life. The FDG-PET study demonstrated unique and pronounced metabolic impairment in the occipital cortex in both patients. The clinical diagnosis of DLB in the sister was confirmed by autopsy. 2. FDG-PET images from 11 patients with Alzheimer's disease (AD), 7 patients with DLB and 10 age-matched normal subjects were obtained and analyzed by the statistical parametric mapping (SPM) method. The SPM demonstrated a widespread metabolic reduction in the DLB group. The reduction was particularly pronounced in the visual association cortex in the DLB group compared to the AD group irrespective of clinical severity of the disease. 3. These findings suggest that functional neuroimaging techniques, including FDG-PET, will provide a valuable diagnostic aid to differentiate DLB from AD, and this will help detect DLB patients in the early stage of the disease.
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Affiliation(s)
- N Okamura
- Department of Geriatric Medicine, Tohoku University School of Medicine, Sendai, Japan
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27
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Spira PJ, Sharpe DM, Halliday G, Cavanagh J, Nicholson GA. Clinical and pathological features of a parkinsonian syndrome in a family with an Ala53Thr ?-synuclein mutation. Ann Neurol 2001. [DOI: 10.1002/ana.67] [Citation(s) in RCA: 279] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Abstract
Diffuse Lewy body disease (DLBD) has been studied from various viewpoints and, although clinical diagnostic criteria for DLBD have been proposed, diagnosis remains difficult. DLBD has been reported to be the second most common form of dementia in the aged, following Alzheimer-type dementia. It has, however, been clinically under-diagnosed. Therefore, the search for diagnostic markers for DLBD must continue. Very recently, 'dementia with Lewy bodies' (DLB) was proposed as a generic term for various forms of dementia with Lewy bodies, including DLBD and similar disorders. Cortical Lewy bodies are the most important pathologic marker for diagnosis of DLBD. At present, however, the mechanism responsible for cortical Lewy body formation has yet to be disclosed.
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Affiliation(s)
- K Kosaka
- Department of Psychiatry, Yokohama City University, Yokohama, Japan.
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29
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Abstract
Although Lewy body dementia (LBD) has received a considerable amount of interest in the last decade, there still exists a certain level of confusion concerning the clinical and neuropathological features associated with this disorder. According to many researchers, LBD represents a distinct dementing illness with specific clinical features. The neuropathological hallmark for this disorder is the Lewy body, a spherical intraneuronal cytoplasmic inclusion originally described in brainstem nuclei in Parkinson's disease. In LBD, Lewy bodies are found in subcortical nuclei, such as the substantia nigra, as well as diffusely in the neocortex. Recently, a consortium on dementia with Lewy bodies was held that established consensus guidelines for the clinical and pathological diagnosis of LBD. This review will focus on the newest developments in LBD, addressing specifically clinical and neuropathological features, diagnostic classification, genetics and potential pharmacotherapy.
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Affiliation(s)
- D F Brown
- Department of Pathology, The University of Texas Southwestern Medical Center, Dallas 75235-9073, USA.
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30
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Abstract
In the last decade, a new degenerative dementia, probably the second most common after Alzheimer's disease (AD), has been increasingly recognized under the consensus name of dementia with Lewy bodies (DLB). This article reviews current clinical, genetic, and pathological DLB data and indicates directions for future research. DLB overlaps in clinical, pathological, and genetic features with AD and Parkinson's disease (PD). Clinically, it is characterized by progressive cognitive impairment with significant fluctuations in alertness, parkinsonism, and psychosis with recurrent hallucinations. The neuropathological hallmarks are the intracytoplasmic inclusions in substantia nigra typical of PD, known as Lewy bodies (LB) but distributed widely throughout paralimbic and neocortical regions. Most of the cases also coexist with a plaque predominant AD. It is probably the unique and differential distribution of the lesions throughout cortical and subcortical structures in each of these disorders that supports a specific clinical syndrome and may ultimately prove most useful in understanding their different etiologies. Several genes have recently been implicated in LB formation. Special interest arises from mutations in the alpha-synuclein gene, which appears to be responsible for autosomal dominant PD in several kindreds. This gene encodes a presynaptic protein, a fragment of which is present in AD plaques. Recent studies show intense and quite specific alpha-synuclein immunoreactivity in LB and related neurites, suggesting a potential role of this protein in the aggregation or precipitation of LB inclusions.
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Affiliation(s)
- E Gómez-Tortosa
- Alzheimer's Disease Research Unit, Massachusetts General Hospital East, Charlestown 02119, USA
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Abstract
Lewy body formation is central to the pathological phenotype of a spectrum of disorders. The most familiar of these is the extrapyramidal syndrome of idiopathic Lewy-body Parkinson's disease (PD). Studies of dementia in the elderly suggest that another manifestation of Lewy body pathology is equally or more common than Parkinson's disease. This syndrome of Dementia with Lewy bodies (DLB) has been given a number of diagnostic labels and is characterised by dementia, relatively mild parkinsonism, visual hallucinations, and fluctuations in conscious level. Although many of these features can arise in Parkinson's disease, the patients with DLB tend to have early neuropsychiatric features which predominate the clinical picture, and the diagnosis of the syndrome in practice is more concerned with the differential diagnosis of Alzheimer's disease (AD). Distinction from AD has clinical importance because of potentially differing therapeutic implications. Diagnostic guidelines for the clinical diagnosis and pathological evaluation of DLB are reviewed. Research into the disorder has centered around characterising the clinical, neuropsychological, pathological, neurochemical and genetic relationships with Alzheimer's disease on the one hand, and Parkinson's disease on the other. Many cases of DLB have prominent pathological features of AD and there are some shared genetic risk factors. Differences from the pathology of PD are predominantly quantitative rather than qualitative and evidence is discussed which suggests that DLB represents a clinicopathological syndrome within the spectrum of Lewy body disorders. The possibility that the syndrome represents a chance association of PD and AD is not supported by published studies.
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Affiliation(s)
- P G Ince
- University of Newcastle upon Tyne, and Department of Neuropathology, Newcastle General Hospital, UK.
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