Almeida Francisco C, Santos Alexandra, Jesus Tiago, Coelho Ana, Quintas-Neves Miguel, Gauthreaux Kathryn, Mock Charles N, Kukull Walter A, Crary John F, Oliveira Tiago Gil
Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus Gualtar, Braga, Portugal.
ICVS/3B's-PT Government Associate Laboratory, Braga, Portugal.
Alzheimers Dement. 2025 Jan;21(1):e14191. doi: 10.1002/alz.14191. Epub 2024 Dec 22.
Alzheimer's disease (AD) co-pathology with Lewy bodies (LB) is frequent and influences clinical manifestations and outcomes. Its significance in primary age-related tauopathy (PART) is unknown. We investigated the influence of LB on cognition and brain atrophy in AD and PART.
We performed a retrospective cohort study in a large sample of autopsied participants with AD neuropathological change (ADNC) with and without LB and PART with and without LB, with corresponding ante mortem magnetic resonance imaging (MRI) data from the National Alzheimer's Coordinating Center dataset.
LB co-pathology worsened cognitive impairment in both PART and ADNC. On longitudinal follow-up, LB impacted cognitive decline in multiple domains. Additionally, LB influenced brain atrophy on MRI across groups and LB regional staging was different in PART and ADNC, accompanying tauopathy progression.
These results suggest that LB co-pathology is associated with divergent patterns of cognitive impairment, brain atrophy, and regional pathological distribution in PART and AD.
Lewy body (LB) co-pathology is frequent in Alzheimer's disease (AD) with important clinical implications. LB co-pathology is also present in primary age-related tauopathy (PART), but its significance is still understudied. In PART and AD, LB leads to higher cognitive impairment and brain regional atrophy. In PART and AD, LB tends to accompany neurofibrillary tangle progression, suggesting amyloid pathology might be a trigger for regional pathology progression.
阿尔茨海默病（AD）与路易小体（LB）的共同病理改变很常见，并影响临床表现和预后。其在原发性年龄相关性tau病（PART）中的意义尚不清楚。我们研究了LB对AD和PART认知及脑萎缩的影响。
我们对大量有或无LB的AD神经病理改变（ADNC）尸检参与者以及有或无LB的PART尸检参与者进行了回顾性队列研究，并使用了来自国家阿尔茨海默病协调中心数据集的相应生前磁共振成像（MRI）数据。
LB共同病理改变使PART和ADNC的认知障碍均恶化。在纵向随访中，LB影响多个领域的认知衰退。此外，LB影响各研究组MRI上的脑萎缩，且PART和ADNC中LB的区域分期不同，并伴随tau病变进展。
这些结果表明，LB共同病理改变与PART和AD中认知障碍、脑萎缩及区域病理分布的不同模式相关。
路易小体（LB）共同病理改变在阿尔茨海默病（AD）中很常见，具有重要临床意义。LB共同病理改变在原发性年龄相关性tau病（PART）中也存在，但其意义仍研究不足。在PART和AD中，LB导致更高的认知障碍和脑区萎缩。在PART和AD中，LB往往伴随神经原纤维缠结进展，提示淀粉样病理可能是区域病理进展的触发因素。
