Objective: To compare established early symptoms and risk factors associated with Parkinson’s disease (PD) in a cohort of incidental Lewy Body disease (iLBD) and healthy controls (HC) to improve the understanding of disease progression and pathological correlation in the early stages of PD.

Background: Individuals without clinical parkinsonism or dementia during life who are found to have Lewy pathology on autopsy (known as iLBD) are considered pre-diagnostic cases of PD although little is known about their clinical and risk marker profile.

Method: Retrospective review of medical records of all available iLBD cases from the archives of the Queen Square and the Imperial College Brain Banks (United Kingdom) and a group of consecutive unselected HC (1:2). We compared the presence and the age at onset of motor, non-motor symptoms and risk markers associated with PD between 29 individuals with iLBD and 59 HC. The severity of symptoms was rated based on the need and the symptomatic response to medication. Prevalence of prodromal PD cases was compared among the two groups by applying the MDS research criteria for prodromal PD.

Results: 29 iLBD (mean age at death 87,38 ± 1.40 years; 24.1% male) and 59 HC (mean age at death 83,12 ± 1,23 years; 37.3% male) were included. The following symptoms were significantly more prevalent in the iLBD group: neurosensory disorders (p=0.0039), cognitive impairment (p=0.014), restless leg syndrome (p=0.012), neck pain (p<0.0001),  low back pain (p=0.007), shoulder pain (p=0.032), early satiety (p=0.041), episodic constipation (p=0.002),  faecal incontinence (p=0.017), autonomic dysfunction (p=0.013), falls (p=0.003), stiffness (p=0.002) and slowness of movement (p=0.003). In the group iLBD, slowness of movement, stiffness, falls, urinary dysfunction, and upper digestive symptoms were more severe compared to HC. Rheumatoid arthritis and regular prescription of NSAIDs were significantly associated with iLBD. 20.7% of iLBD cases fulfil criteria for prodromal PD whilst only 1.7% in HC group.

Conclusion: iLBD cases showed a clinical and risk marker profile similar to PD. A better understanding of clinico-pathological correlations in prodromal PD / iLBD is crucial for the ultimate goal of early intervention with disease modifying therapies.

« Back to 2022 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/incidental-lewy-body-disease-and-idiopathic-parkinsons-disease-from-common-pathogenic-factors-to-the-overlapping-clinical-features/