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Article
October 18, 1995

Lewy Body Pathology and Heterogeneity of Alzheimer's Disease

Author Affiliations

PierFranco Spano Brescia University School of Medicine Brescia, Italy

JAMA. 1995;274(15):1199. doi:10.1001/jama.1995.03530150023022
Abstract

To the Editor.  —A primary goal of research related to Alzheimer's disease (AD) is to characterize subtypes of the disease amenable to specific therapeutic interventions. Recent investigations indicated that concomitant or independently occurring Lewy body (LB) pathology represents one of the largest variants of clinically diagnosed AD. This neuropathological entity is characterized by eosinophilic intracytoplasmic inclusion bodies disseminated in the neocortex, limbic areas, and brain stem nuclei and usually occurring with pathologic changes characteristic of moderate AD. Although clinical criteria for the identification of LB dementia (fluctuation in impairment of cognitive functions, hallucinations often leading to paranoid delusions, unexplained falls and/or loss of consciousness, extrapyramidal features, and neuroleptic hypersensitivity) are not firmly established, interest in LB dementia as an independent nosographic entity1 is growing.The postmortem examination of LB-affected brains provides a set of neuropathological features2 that more clearly, although not unequivocally, differentiate LB dementia from typical, neuropathologically

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