Concomitant pathologies among a spectrum of parkinsonian disorders

Brittany N. Dugger, Charles Howard Adler, Holly A. Shill, John Nathaniel Caviness, Sandra Jacobson, Erika M Driver-Dunckley, Thomas G. Beach

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)525-529
Number of pages5
JournalParkinsonism and Related Disorders
Volume20
Issue number5
DOIs
StatePublished - 2014

Fingerprint

Cerebral Amyloid Angiopathy
Parkinsonian Disorders
Pathology
Alzheimer Disease
Progressive Supranuclear Palsy
Lewy Body Disease
Brain Diseases
Neurodegenerative Diseases
Atrophy
Parkinson Disease
White Matter
Primary Spontaneous Pneumothorax

Keywords

  • Alzheimer's disease
  • Argyrophilic grains
  • Cerebral amyloid angiopathy
  • Parkinson's disease
  • Vascular dementia
  • White matter rarefaction

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Clinical Neurology
  • Neurology
  • Medicine(all)

Cite this

Concomitant pathologies among a spectrum of parkinsonian disorders. / Dugger, Brittany N.; Adler, Charles Howard; Shill, Holly A.; Caviness, John Nathaniel; Jacobson, Sandra; Driver-Dunckley, Erika M; Beach, Thomas G.

In: Parkinsonism and Related Disorders, Vol. 20, No. 5, 2014, p. 525-529.

Research output: Contribution to journalArticle

Dugger, Brittany N. ; Adler, Charles Howard ; Shill, Holly A. ; Caviness, John Nathaniel ; Jacobson, Sandra ; Driver-Dunckley, Erika M ; Beach, Thomas G. / Concomitant pathologies among a spectrum of parkinsonian disorders. In: Parkinsonism and Related Disorders. 2014 ; Vol. 20, No. 5. pp. 525-529.
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abstract = "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.",
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AU - Dugger, Brittany N.

AU - Adler, Charles Howard

AU - Shill, Holly A.

AU - Caviness, John Nathaniel

AU - Jacobson, Sandra

AU - Driver-Dunckley, Erika M

AU - Beach, Thomas G.

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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.

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KW - Cerebral amyloid angiopathy

KW - Parkinson's disease

KW - Vascular dementia

KW - White matter rarefaction

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