Lewy Body Disease: Point Towards Progressive Dementia

Lewy Body Disease: Point Towards Progressive Dementia

Vaibhav Walia (Maharshi Dayanand University, India) and Munish Garg (Maharshi Dayanand University, India)
DOI: 10.4018/978-1-5225-5282-6.ch014

Abstract

Fritz Heinrich Lewy described the intracytoplasmic inclusions found in the neurons for the very first time. In 1919 these inclusions were termed as “LBs” by Tretiakoff. LBs were found in the brain of the patients suffering from Lewy body disease (LBD). LBD is characterized by the presence of Parkinsonian symptoms in the earlier stages and dementia in the later stages of the disease. LBs were classified on the basis of the region of the brain in which they are distributed and so is the case of the LBD means the type of the LBD depends on the anatomical areas of the brain involved. LBD is not a single disorder. It is a spectrum of disorders. This chapter addresses the entire profile of LBs, types, composition, formation, and various LB pathologies as well as diagnostic criteria and pharmacotherapy.
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Background

LBs are the intracytoplasmic inclusions found in the neurons of the patients suffering from LBD, however the exact type of the LBD which a patients exactly suffers from depends upon the region of brain in which the LBs were found predominantly (Kalra et al, 1996). Brainstem nuclei involvement is almost universal in the LBD while the involvement of limbic region and neocortex suggested the progression of disease (Braak et al, 2003). Further it is suggested that the brainstem is involved in the early stages of LBs pathologies whereas the different region of brain also involved when the disease progresses or in the later stages of the disease (Adler et al, 2010). LBs pathologies or the LBD represent a family of the disease that involved three distinct pathologies including PD, PDD and DLB. Before going in to the depth involved in the pathogenesis of these pathologies it remains of interest how LBs occurs and what is the reason of LBs formation. Recent reports suggested that the dopaminergic neurons isolated from the healthy individuals when implanted in the brain of the PD patients form LBs (Kordower et al, 2008; Li et al, 2008) suggesting LBs formations occurs to counteract the pathological insult. Thus LBs formation represents an epiphenomenon, or the scars of neurodegeneration (Popescu et al, 2004). In the present work authors demonstrate the different types of LBs, their formation and composition and the occurrence of LBs in various LBD.

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