Amygdala-predominant Lewy bodies associate with cognitive decline and amygdala atrophy in Alzheimer's disease neuropathological change.

INTRODUCTION

Amygdala-predominant Lewy body (LB) pathology occurs frequently in association with advanced Alzheimer's disease (AD). Its clinical significance is not yet fully clarified. We investigated the influence of amygdala-predominant LB in cognitive profiles and brain atrophy in the context of AD neuropathological change (ADNC).

METHODS

We performed a retrospective cohort study from the National Alzheimer's Coordinating Center dataset assessing the influence of amygdala-predominant LB and caudo-rostral LB stages in longitudinal neuropsychological and cognitive testing, as well as on regional brain volume in cross-sectional MRI.

RESULTS

Amygdala-predominant LB associated with specific deficits in neuropsychological testing compared with those without LB and with limbic LB (p ≤ 0.05). This was accompanied by focal atrophy of the right amygdala compared with those without LB co-pathology (p ≈ 0.02), although this result did not survive false discovery rate correction.

DISCUSSION

These results suggest that amygdala-predominant LB is an important form of co-pathology in ADNC, associating with cognitive decline and focal brain atrophy.