A case of concomitant dementia with Lewy bodies and argyrophilic grain disease with prominent psychiatric symptoms

This chapter describes the main neuropathological features of the most common age-associated neurodegenerative diseases, including Alzheimer’s disease, Parkinson’s disease, and dementia with Lewy bodies, as well as other less frequent ones such as multiple system atrophy, Pick’s disease, corticobasal degeneration, progressive supranuclear palsy, argyrophilic grain disease, neurofibrillary tangle-dominant dementia, frontotemporal lobar degeneration with TDP-43 pathology, and Huntington’s disease. Likewise, cerebral amyloid angiopathy, hippocampal sclerosis, vascular dementia, and prion diseases are described. A main aim of this chapter is to assist the reader in interpreting neuropathological reports; hence criteria for the neuropathological classifications of the major diseases are provided. One section covers general considerations on neurodegeneration, and basic pathophysiological mechanisms of tau, amyloid-β‎, α‎-synuclein, TDP-43, and prions are briefly described in the sections on the respective diseases. Finally, one section is dedicated to cerebral multimorbidity, and a view on currently emerging neuropathological methods is given.

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Assessing Nigrostriatal Dopaminergic Pathways via 123I-FP-CIT SPECT in Dementia With Lewy Bodies in a Psychiatric Patient Cohort

Frontiers in Aging Neuroscience ◽

10.3389/fnagi.2021.672956 ◽

2021 ◽

Vol 13 ◽

Author(s):

Niels Hansen ◽

Claudia Lange ◽

Charles Timäus ◽

Jens Wiltfang ◽

Caroline Bouter

Keyword(s):

Dementia With Lewy Bodies ◽

Psychiatric Symptoms ◽

Single Photon ◽

Medical Center ◽

Psychiatric Patients ◽

Photon Emission ◽

Lewy Bodies ◽

Emission Computed Tomography ◽

Psychiatric Symptomatology ◽

Memory Clinics

Background(123)-I-2-ß-carbomethoxy-3ß-(4-iodophenyl)-N-(3-fluoropropyl) nortro- pane single photon emission computed tomography (123I-FP-CIT SPECT) was validated to distinguish Alzheimer’s dementia from dementia with Lewy Bodies (DLB) by European medical agencies. Little evidence exists that validates 123 I-FP-CIT SPECT as a supplementary method to diagnose probable DLB in a psychiatric cohort of patients with psychiatric symptomatology and suspected DLB. We aim to elucidate differences in the clinical phenotype of DLB between those patients with and those without a positive 123 I-FP-CIT SPECT indicating a nigrostriatal deficit.MethodsTo investigate this, we included 67 patients from the Department of Psychiatry and Psychotherapy at University Medical Center Göttingen (UMG) in our study who had undergone 123I-FP-CIT SPECT in the Department of Nuclear Medicine (UMG) by evaluating their patient files.Results55% with a positive-123I-FP-CIT SPECT and probable DLB after the 123I-FP-CIT SPECT exhibited psychiatric features. The number of probable DLB patients in those exhibiting psychiatric symptoms was higher post-123I-FP-CIT SPECT than pre-123I-FP-CIT SPECT assessed cross-sectionally over a 6-year period (p < 0.05). In addition, prodromal DLB and prodromal DLB patients with a psychiatric-phenotype yielded higher numbers post-123I-FP-CIT SPECT than pre-123I-FP-CIT SPECT (p < 0.05). Furthermore, we discovered no phenotypical differences between those DLB patients with a positive and those with a negative 123I-FP-CIT SPECT. 123I-FP-CIT SPECT-positive DLB patients in our psychiatric cohort revealed a psychiatric onset more often (52%); DLB was less often characterized by an MCI onset (26%) (p < 0.005).ConclusionsOur findings support 123I-FP-CIT SPECT as an adjuvant tool for improving the diagnosis of probable DLB and prodromal DLB in a cohort of psychiatric patients with often concomitant psychiatric symptomatology. The psychiatric-onset is more frequent than an MCI-onset in DLB patients presenting nigrostriatal dysfunction, giving us an indication of the relevance of deep clinical phenotyping in memory clinics that includes the assessment of psychopathology.

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Prominent psychiatric symptoms in patients with Parkinson’s disease and concomitant argyrophilic grain disease

Journal of Neurology ◽

10.1007/s00415-013-7101-1 ◽

2013 ◽

Vol 260 (12) ◽

pp. 3002-3009 ◽

Cited By ~ 12

Author(s):

O. Grau-Rivera ◽

E. Gelpi ◽

M. J. Rey ◽

F. Valldeoriola ◽

E. Tolosa ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Psychiatric Symptoms ◽

Argyrophilic Grain Disease ◽

Argyrophilic Grain

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Locus Coeruleus Malfunction Is Linked to Psychopathology in Prodromal Dementia With Lewy Bodies

Frontiers in Aging Neuroscience ◽

10.3389/fnagi.2021.641101 ◽

2021 ◽

Vol 13 ◽

Author(s):

Niels Hansen

Keyword(s):

Locus Coeruleus ◽

Dementia With Lewy Bodies ◽

Psychiatric Symptoms ◽

Lewy Bodies ◽

Neuronal Loss ◽

Alpha Synuclein ◽

Narrative Review ◽

Noradrenergic Neurons ◽

Prodromal Dementia ◽

The Relationship

Background: The locus coeruleus (LC) is a nucleus in the human brainstem with a variety of noradrenaline-driven functions involved in cognition, emotions, and perception. Dementia with Lewy bodies (DLB) constitutes a neurodegenerative disease involving deposits of alpha-synuclein, first appearing in the brainstem. The goal of this narrative review is to delineate the relationship between the expression of psychiatric symptoms as an early-onset of DLB and the degeneration of the LC's noradrenaline system.Methods: We searched in PubMed for relevant articles concerning LC degeneration and psychiatric symptoms in prodromal DLB in this narrative review. We rely on the McKeith criteria for prodromal psychiatric DLB.Results: We found four studies that document neuronal loss, deposits of Lewy bodies and other hints for neurodegeneration in the LC in patients with DLB. Furthermore, we reviewed theories and studies on how the degenerated noradrenaline LC system contributes to psychiatric DLB's phenotype. We hypothesized how anxiety, hallucinations, delusions, and depressive symptoms might occur in DLB patients due to degenerated noradrenergic neurons entailing consecutive altered noradrenergic transmission in the LC's projection areas.Conclusions: LC degeneration in prodromal DLB might cause psychiatric symptoms as the first and non-motor manifestation of DLB, as the LC is affected earlier by degeneration than are dopaminergic structures such as the substantia nigra, which are impaired later in the disease course.

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Psychiatric symptoms typical of patients with dementia with Lewy bodies – similarity to those of levodopa-induced psychosis

Acta Neuropsychiatrica ◽

10.1034/j.1601-5215.2002.140507.x ◽

2002 ◽

Vol 14 (5) ◽

pp. 237-241 ◽

Cited By ~ 10

Author(s):

Eizo Iseki ◽

Wami Marui ◽

Namiko Nihashi ◽

Kenji Kosaka

Keyword(s):

Dopamine Receptor ◽

Dementia With Lewy Bodies ◽

Visual Illusion ◽

Psychiatric Symptoms ◽

Lewy Bodies ◽

Occipital Lobe ◽

Reciprocal Connections ◽

Capgras Syndrome ◽

Reduplicative Paramnesia ◽

Glucose Hypometabolism

We examined psychiatric symptoms in eight cases with dementia with Lewy bodies (DLB), which included visual hallucination of persons or small animals, visual illusion, metamorphosia, leibhaftige Bewusstheit, personal or topographical misidentification, Capgras' syndrome and reduplicative paramnesia as well as depressive state and delusion of persecution. These psychiatric symptoms are identical to those of levodopa-induced psychosis, although these symptoms appeared before medication with anti-Parkinson drugs. The hypersensitivity of the dopamine receptor in the meso-limbic dopaminergic system has been presumed in levodopa-induced psychosis. We previously showed disturbance of the nigro-amygdaloid dopaminergic connections in DLB brains on pathological studies. Hypoperfusion or glucose hypometabolism in the occipital lobe has been demonstrated in DLB patients using SPECT or PET. The amygdala has reciprocal connections with the visual cortex in the occipital lobe. From these findings, it is supposed that the disturbance of the nigro-amygdaloid connections induces hypersensitivity of the dopamine receptor in the amygdala, causing psychiatric symptoms with dysfunction of the visuo-amygdaloid connections.

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A case of dementia with Lewy bodies that showed improvement in both psychiatric symptoms and Parkinsonisms by combination therapy of risperidone and L-dopa

International Clinical Psychopharmacology ◽

10.1097/00004850-200109000-00043 ◽

2001 ◽

Vol 16 (5) ◽

pp. 305

Author(s):

Kimiyasu Kato ◽

Tadashi Wada ◽

Shinobu Kawakatsu ◽

Koichi Otani

Keyword(s):

Combination Therapy ◽

Dementia With Lewy Bodies ◽

Psychiatric Symptoms ◽

Lewy Bodies

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The Progression of Cognition, Psychiatric Symptoms, and Functional Abilities in Dementia With Lewy Bodies and Alzheimer Disease

Archives of Neurology ◽

10.1001/archneur.63.10.1450 ◽

2006 ◽

Vol 63 (10) ◽

pp. 1450 ◽

Cited By ~ 61

Author(s):

Karina Stavitsky ◽

Adam M. Brickman ◽

Nikolaos Scarmeas ◽

Rebecca L. Torgan ◽

Ming-Xin Tang ◽

...

Keyword(s):

Alzheimer Disease ◽

Dementia With Lewy Bodies ◽

Psychiatric Symptoms ◽

Lewy Bodies ◽

Functional Abilities

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A comparative study of psychiatric symptoms in dementia with Lewy bodies and Parkinson's disease with and without dementia

International Journal of Geriatric Psychiatry ◽

10.1002/gps.389 ◽

2001 ◽

Vol 16 (5) ◽

pp. 528-536 ◽

Cited By ~ 174

Author(s):

Dag Aarsland ◽

Clive Ballard ◽

Jan P. Larsen ◽

Ian McKeith

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Comparative Study ◽

Dementia With Lewy Bodies ◽

Psychiatric Symptoms ◽

Lewy Bodies

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Neuropathology

10.1093/med/9780199644957.003.0006 ◽

2013 ◽

Cited By ~ 1

Author(s):

Johannes Attems ◽

Kurt A. Jellinger

Keyword(s):

Prion Diseases ◽

Hippocampal Sclerosis ◽

Neurofibrillary Tangle ◽

Lewy Bodies ◽

Amyloid Β ◽

Corticobasal Degeneration ◽

Amyloid Angiopathy ◽

Argyrophilic Grain Disease ◽

Argyrophilic Grain ◽

Cerebral Amyloid

This chapter describes the main neuropathological features of the most common age associated neurodegenerative diseases including Alzheimer's disease, Parkinson's disease and dementia with Lewy bodies as well as other less frequent ones such as multiple system atrophy, Pick's disease, corticobasal degeneration, progressive supranuclear palsy, argyrophilic grain disease, neurofibrillary tangle dominant dementia, frontotemporal lobar degeneration with TDP-43 pathology and Huntington's disease. Likewise cerebral amyloid angiopathy, hippocampal sclerosis, vascular dementia and prion diseases are described. A main aim of this chapter is to assist the reader in interpreting neuropathological reports, hence criteria for the neuropathological classifications of the major diseases are provided. One section covers general considerations on neurodegeneration and basic pathophysiological mechanisms of tau, amyloid-β, α-synuclein, TDP-43 and prions are briefly described in the sections on the respective diseases. Finally, one section is dedicated to cerebral multimorbidity and we give a view on currently emerging neuropathological methods.

Download Full-text