TY - JOUR
T1 - Concomitant pathologies among a spectrum of parkinsonian disorders
AU - Dugger, Brittany N.
AU - Adler, Charles H.
AU - Shill, Holly A.
AU - Caviness, John
AU - Jacobson, Sandra
AU - Driver-Dunckley, Erika
AU - Beach, Thomas G.
N1 - Funding Information:
The authors thank the patients and their families for their participation in the study. The Brain and Body Donation Program is supported by the National Institute of Neurological Disorders and Stroke (U24 NS072026 National Brain and Tissue Resource for Parkinson's Disease and Related Disorders), the National Institute on Aging (P30 AG19610 Arizona Alzheimer's Disease Core Center), and the Michael J. Fox Foundation for Parkinson's Research .
PY - 2014/5
Y1 - 2014/5
N2 - Introduction: Many clinicopathological studies do not specify the presence of other pathologies located within the brain, so disease heterogeneity may be under appreciated. Objective: The purpose of this study was to determine the frequencies of concomitant pathologies among parkinsonian disorders. Methods: Data from the Arizona Study of Aging and Neurodegenerative Disorders (AZSAND), an ongoing longitudinal clinical-neuropathological study, was used to analyze concomitant pathologies, including Alzheimer's disease (AD), argyrophilic grains (Arg), cerebral amyloid angiopathy (CAA), cerebral white matter rarefaction (CWMR) and overlap of each parkinsonian disorder in clinico-pathologically defined Parkinson's disease (PD; N=140), dementia with Lewy bodies (DLB; N=90), progressive supranuclear palsy (PSP; N=64), m. ultiple system atrophy (MSA; N=6), corticobasal degeneration (CBD; N=7); and normal elderly (controls; N=166). Results: Of the neuropathologically-confirmed PD cases, 38% had a concomitant diagnosis of AD, 9% PSP, 25% Arg, 44% CWMR, and 24% CAA. For DLB, 89% had AD, 1% PSP, 21% Arg, 51% CWMR, and 50% CAA. For PSP cases, 36% had AD, 20% PD, 1% DLB, 44% Arg, 52% CWMR and 25% CAA. Similar heterogeneity was seen for MSA and CBD cases. Many cases had more than one of the above additional diagnoses. Conclusions: These data demonstrate a great deal of concomitant pathologies among different types of parkinsonian disorders; this may help explain the heterogeneity of clinical findings.
AB - Introduction: Many clinicopathological studies do not specify the presence of other pathologies located within the brain, so disease heterogeneity may be under appreciated. Objective: The purpose of this study was to determine the frequencies of concomitant pathologies among parkinsonian disorders. Methods: Data from the Arizona Study of Aging and Neurodegenerative Disorders (AZSAND), an ongoing longitudinal clinical-neuropathological study, was used to analyze concomitant pathologies, including Alzheimer's disease (AD), argyrophilic grains (Arg), cerebral amyloid angiopathy (CAA), cerebral white matter rarefaction (CWMR) and overlap of each parkinsonian disorder in clinico-pathologically defined Parkinson's disease (PD; N=140), dementia with Lewy bodies (DLB; N=90), progressive supranuclear palsy (PSP; N=64), m. ultiple system atrophy (MSA; N=6), corticobasal degeneration (CBD; N=7); and normal elderly (controls; N=166). Results: Of the neuropathologically-confirmed PD cases, 38% had a concomitant diagnosis of AD, 9% PSP, 25% Arg, 44% CWMR, and 24% CAA. For DLB, 89% had AD, 1% PSP, 21% Arg, 51% CWMR, and 50% CAA. For PSP cases, 36% had AD, 20% PD, 1% DLB, 44% Arg, 52% CWMR and 25% CAA. Similar heterogeneity was seen for MSA and CBD cases. Many cases had more than one of the above additional diagnoses. Conclusions: These data demonstrate a great deal of concomitant pathologies among different types of parkinsonian disorders; this may help explain the heterogeneity of clinical findings.
KW - Alzheimer's disease
KW - Argyrophilic grains
KW - Cerebral amyloid angiopathy
KW - Parkinson's disease
KW - Vascular dementia
KW - White matter rarefaction
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U2 - 10.1016/j.parkreldis.2014.02.012
DO - 10.1016/j.parkreldis.2014.02.012
M3 - Article
C2 - 24637124
AN - SCOPUS:84899995359
SN - 1353-8020
VL - 20
SP - 525
EP - 529
JO - Parkinsonism and Related Disorders
JF - Parkinsonism and Related Disorders
IS - 5
ER -