Volume 17, Issue 6 p. 1161-1165
Research Article

Parkinson's disease and dementia with Lewy bodies: One disease or two?

Irene Hegeman Richard MD

Corresponding Author

Irene Hegeman Richard MD

University of Rochester School of Medicine and Dentistry, Department of Neurology, Rochester, New York, USA

University of Rochester School of Medicine and Dentistry, Department of Neurology, 601 Elmwood Avenue, Rochester, NY 14642Search for more papers by this author
Michelle Papka PhD

Michelle Papka PhD

University of Rochester School of Medicine and Dentistry, Department of Neurology, Rochester, New York, USA

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Ana Rubio MD, PhD

Ana Rubio MD, PhD

University of Rochester School of Medicine and Dentistry, Department of Pathology (Section of Neuropathology), Rochester, New York, USA

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Roger Kurlan MD

Roger Kurlan MD

University of Rochester School of Medicine and Dentistry, Department of Neurology, Rochester, New York, USA

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First published: 24 June 2002
Citations: 54

Abstract

Parkinson's disease (PD) and dementia with Lewy bodies (DLB) have clinical features in common and are both characterized neuropathologically by the presence of Lewy bodies (LBs). We conducted a clinicopathological correlation pilot study to better understand whether PD and DLB represent two distinct nosological entities or rather exist along the spectrum of a single LB disease. A neuropathologist blinded to clinical diagnoses evaluated brains with largely pure LB pathology to determine LB distribution and frequency. Research clinicians blinded to LB distribution and frequency determined consensus clinical diagnoses. Clinical features separated cases into two groups, one having features most compatible with PD and the other with DLB. The groups were distinguishable mainly by the time course of clinical symptoms. Although the presence of neocortical LBs was more common in the group of patients with clinical features of DLB, neocortical LBs were also present in 1 member of the PD group and even in the clinically normal control subject. Thus, there appear to be two clinical syndromes, distinguished mainly by the time course of symptoms. The mechanisms responsible for the different clinical presentations are not known, and the issue of whether PD and DLB represent two distinct diseases remains unsettled. © 2002 Movement Disorder Society