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01-01-2021 | Autopsy | Original Paper

Lewy pathology of the esophagus correlates with the progression of Lewy body disease: a Japanese cohort study of autopsy cases

Authors: Zen-ichi Tanei, Yuko Saito, Shinji Ito, Tomoyasu Matsubara, Atsuko Motoda, Mikihiro Yamazaki, Yasuhiro Sakashita, Ito Kawakami, Masako Ikemura, Shinya Tanaka, Renpei Sengoku, Tomio Arai, Shigeo Murayama

Published in: Acta Neuropathologica | Issue 1/2021

Abstract

Lewy body disease (LBD) is a spectrum of progressive neurodegenerative disorders characterized by the wide distribution of Lewy bodies and neurites in the central and peripheral nervous system (CNS, PNS). Clinical diagnoses include Parkinson’s disease (PD), dementia with Lewy bodies, or pure autonomic failure. All types of LBD are accompanied by non-motor symptoms (NMSs) including gastrointestinal dysfunctions such as constipation. Its relationship to Lewy body-related α-synucleinopathy (Lewy pathology) of the enteric nervous system (ENS) is attracting attention because it can precede the motor symptoms. To clarify the role of ENS Lewy pathology in disease progression, we performed a clinicopathological study using the Brain Bank for Aging Research in Japan. Five-hundred and eighteen cases were enrolled in the study. Lewy pathology of the CNS and PNS, including the lower esophagus as a representative of the ENS, was examined via autopsy findings. Results showed that one-third of older people (178 cases, 34%) exhibited Lewy pathology, of which 78 cases (43.8%) exhibited the pathology in the esophagus. In the esophageal wall, Auerbach’s plexus (41.6%) was most susceptible to the pathology, followed by the adventitia (33.1%) and Meissner’s plexus (14.6%). Lewy pathology of the esophagus was significantly associated with autonomic failures such as constipation (p < 0.0001) and among PNS regions, correlated the most with LBD progression (r = 0.95, p < 0.05). These findings suggest that the propagation of esophageal Lewy pathology is a predictive factor of LBD.

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Title: Lewy pathology of the esophagus correlates with the progression of Lewy body disease: a Japanese cohort study of autopsy cases
Authors: Zen-ichi Tanei
Yuko Saito
Shinji Ito
Tomoyasu Matsubara
Atsuko Motoda
Mikihiro Yamazaki
Yasuhiro Sakashita
Ito Kawakami
Masako Ikemura
Shinya Tanaka
Renpei Sengoku
Tomio Arai
Shigeo Murayama
Publication date: 01-01-2021
Publisher: Springer Berlin Heidelberg
Keywords: Autopsy
Dementia
Pathology
Parkinson's Disease
Dementia
Published in: Acta Neuropathologica / Issue 1/2021
Print ISSN: 0001-6322
Electronic ISSN: 1432-0533
DOI: https://doi.org/10.1007/s00401-020-02233-8

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Abstract

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Abstract

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