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

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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: Tanei, Zen-ichi Browse this author →KAKEN DB
Saito, Yuko Browse this author
Ito, Shinji Browse this author
Matsubara, Tomoyasu Browse this author
Motoda, Atsuko Browse this author
Yamazaki, Mikihiro Browse this author
Sakashita, Yasuhiro Browse this author
Kawakami, Ito Browse this author
Ikemura, Masako Browse this author
Tanaka, Shinya Browse this author →KAKEN DB
Sengoku, Renpei Browse this author
Arai, Tomio Browse this author
Murayama, Shigeo Browse this author
Keywords: Lewy body disease
Parkinson’s disease
Enteric nervous system
Peripheral nervous system
Issue Date: Jan-2021
Publisher: Springer
Journal Title: Acta Neuropathologica
Volume: 141
Start Page: 25
End Page: 37
Publisher DOI: 10.1007/s00401-020-02233-8
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 alpha-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.
Type: article
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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