Lateralized ante mortem and post mortem pathology in a case of Lewy body disease with corticobasal syndrome
Abstract Introduction Lewy body diseases are pathologically characterized by α‐synuclein pathology. Alzheimer's disease (AD) co‐pathology can influence phenotypes. In vivo AD biomarkers can suggest the presence of this co‐pathology in unusual cases, but pathological validation remains essential...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | Alzheimer’s & Dementia: Translational Research & Clinical Interventions |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/trc2.12294 |
| _version_ | 1797948964966760448 |
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| author | David G. Coughlin H. Branch Coslett Claire Peterson Jeffrey S. Phillips Corey McMillan Edward B. Lee John Q. Trojanowski Murray Grossman David J. Irwin |
| author_facet | David G. Coughlin H. Branch Coslett Claire Peterson Jeffrey S. Phillips Corey McMillan Edward B. Lee John Q. Trojanowski Murray Grossman David J. Irwin |
| author_sort | David G. Coughlin |
| collection | DOAJ |
| description | Abstract Introduction Lewy body diseases are pathologically characterized by α‐synuclein pathology. Alzheimer's disease (AD) co‐pathology can influence phenotypes. In vivo AD biomarkers can suggest the presence of this co‐pathology in unusual cases, but pathological validation remains essential. Methods This patient originally presented with corticobasal syndrome and later developed visual hallucinations and parkinsonism consistent with a synucleinopathy. The patient underwent CSF sampling, 18F‐flortaucipir PET scanning, and brain donation with bilateral regions available for digital histological analysis. Results CSF Aβ42 and t‐tau were in the AD range. 18F‐flortaucipir scanning showed right‐lateralized retention in all lobes (t = 4.3‐10.0, P < .006). Neocortical stage Lewy body pathology and high levels of AD neuropathological changes were present at autopsy. There was right lateralization of α‐synuclein and tau pathology (T value = 3.1, P value = .007 and T value = 3.3, P value = .004 respectively). Discussion This case with overlapping tauopathy and synucleinopathy clinical features had in‐depth biomarker characterization and rare bilateral post‐mortem sampling showing lateralized tau and α‐synuclein pathology suggesting possible synergistic relationships. |
| first_indexed | 2024-04-10T21:52:56Z |
| format | Article |
| id | doaj.art-08c1dc227b1d40899f01c3f14a58ef8b |
| institution | Directory Open Access Journal |
| issn | 2352-8737 |
| language | English |
| last_indexed | 2024-04-10T21:52:56Z |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Alzheimer’s & Dementia: Translational Research & Clinical Interventions |
| spelling | doaj.art-08c1dc227b1d40899f01c3f14a58ef8b2023-01-18T11:41:04ZengWileyAlzheimer’s & Dementia: Translational Research & Clinical Interventions2352-87372022-01-0181n/an/a10.1002/trc2.12294Lateralized ante mortem and post mortem pathology in a case of Lewy body disease with corticobasal syndromeDavid G. Coughlin0H. Branch Coslett1Claire Peterson2Jeffrey S. Phillips3Corey McMillan4Edward B. Lee5John Q. Trojanowski6Murray Grossman7David J. Irwin8Department of Neurosciences University of California San Diego La Jolla California USADepartment of Neurology University of Pennsylvania Philadelphia Pennsylvania USADepartment of Neurology University of Pennsylvania Philadelphia Pennsylvania USADepartment of Neurology University of Pennsylvania Philadelphia Pennsylvania USADepartment of Neurology University of Pennsylvania Philadelphia Pennsylvania USADepartment of Pathology and Laboratory Medicine University of Pennsylvania Philadelphia Pennsylvania USADepartment of Pathology and Laboratory Medicine University of Pennsylvania Philadelphia Pennsylvania USADepartment of Neurology University of Pennsylvania Philadelphia Pennsylvania USADepartment of Neurology University of Pennsylvania Philadelphia Pennsylvania USAAbstract Introduction Lewy body diseases are pathologically characterized by α‐synuclein pathology. Alzheimer's disease (AD) co‐pathology can influence phenotypes. In vivo AD biomarkers can suggest the presence of this co‐pathology in unusual cases, but pathological validation remains essential. Methods This patient originally presented with corticobasal syndrome and later developed visual hallucinations and parkinsonism consistent with a synucleinopathy. The patient underwent CSF sampling, 18F‐flortaucipir PET scanning, and brain donation with bilateral regions available for digital histological analysis. Results CSF Aβ42 and t‐tau were in the AD range. 18F‐flortaucipir scanning showed right‐lateralized retention in all lobes (t = 4.3‐10.0, P < .006). Neocortical stage Lewy body pathology and high levels of AD neuropathological changes were present at autopsy. There was right lateralization of α‐synuclein and tau pathology (T value = 3.1, P value = .007 and T value = 3.3, P value = .004 respectively). Discussion This case with overlapping tauopathy and synucleinopathy clinical features had in‐depth biomarker characterization and rare bilateral post‐mortem sampling showing lateralized tau and α‐synuclein pathology suggesting possible synergistic relationships.https://doi.org/10.1002/trc2.12294alpha‐synucleinAlzheimer's diseasecerebrospinal fluidcorticobasal syndromeflortaucipirLewy body dementia |
| spellingShingle | David G. Coughlin H. Branch Coslett Claire Peterson Jeffrey S. Phillips Corey McMillan Edward B. Lee John Q. Trojanowski Murray Grossman David J. Irwin Lateralized ante mortem and post mortem pathology in a case of Lewy body disease with corticobasal syndrome Alzheimer’s & Dementia: Translational Research & Clinical Interventions alpha‐synuclein Alzheimer's disease cerebrospinal fluid corticobasal syndrome flortaucipir Lewy body dementia |
| title | Lateralized ante mortem and post mortem pathology in a case of Lewy body disease with corticobasal syndrome |
| title_full | Lateralized ante mortem and post mortem pathology in a case of Lewy body disease with corticobasal syndrome |
| title_fullStr | Lateralized ante mortem and post mortem pathology in a case of Lewy body disease with corticobasal syndrome |
| title_full_unstemmed | Lateralized ante mortem and post mortem pathology in a case of Lewy body disease with corticobasal syndrome |
| title_short | Lateralized ante mortem and post mortem pathology in a case of Lewy body disease with corticobasal syndrome |
| title_sort | lateralized ante mortem and post mortem pathology in a case of lewy body disease with corticobasal syndrome |
| topic | alpha‐synuclein Alzheimer's disease cerebrospinal fluid corticobasal syndrome flortaucipir Lewy body dementia |
| url | https://doi.org/10.1002/trc2.12294 |
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