Journal
NEUROPATHOLOGY AND APPLIED NEUROBIOLOGY
Volume 42, Issue 4, Pages 366-376Publisher
WILEY-BLACKWELL
DOI: 10.1111/nan.12249
Keywords
dementia with Lewy bodies; fMRI; lateral geniculate nucleus; neuropathology; stereology
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Funding
- UK Medical Research Council [G0400074]
- NIHR Newcastle Biomedical Research Centre and Unit
- Alzheimer's Research UK
- Alzheimer's Society
- Wellcome Trust
- NHS National Institute of Health Research Biomedical Research Unit for Lewy body dementia
- NHS National Institute of Health Research Biomedical Research Unit for Lewy body dementia, from the Yvonne Emily Mairy bequest
- Alzheimer's Society [181] Funding Source: researchfish
- Medical Research Council [MR/L016451/1, G0900652, G1100540, G0502157, G0400074] Funding Source: researchfish
- National Institute for Health Research [NF-SI-0611-10048] Funding Source: researchfish
- MRC [MR/L016451/1, G1100540, G0900652, G0502157, G0400074] Funding Source: UKRI
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AimsComplex visual hallucinations occur in 70% of dementia with Lewy bodies (DLB) cases and significantly affect patient well-being. Visuo-cortical and retinal abnormalities have been recorded in DLB and may play a role in visual hallucinations. The present study aimed to investigate the lateral geniculate nucleus (LGN), a visual relay centre between the retina and visual cortex, to see if changes to this structure underlie visual hallucinations in DLB. MethodsFifty-one [17 probable DLB, 19 control and 15 probable Alzheimer's disease (AD)] cases were recruited for a functional magnetic resonance imaging study, in which patients' response to a flashing checkerboard stimulus was detected and measured in the LGN, before comparison across experimental groups. Additionally, post mortemLGN tissue was acquired for a cross-sectional study using 20 (six DLB, seven control and seven AD) cases and analysed using stereology. -Synuclein, phosphorylated tau and amyloid- pathology was also assessed in all cases. ResultsDLB cases did not significantly differ from controls on neuroimaging, morphometry or pathology. However, a significant increase in amyloid- pathology, a reduction in number of parvocellular neurones and magnocellular gliosis was found in AD cases compared with control and DLB cases. ConclusionsThese findings suggest that the early visual system is relatively spared in DLB, which implies that upstream visual structures may be largely responsible for the generation of hallucinatory percepts. The significance of the degeneration of the LGN in AD cases is uncertain.
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