Neuronal Loss and Α-Synuclein Pathology in the Superior Colliculus and Its Relationship to Visual Hallucinations in Dementia with Lewy Bodies

Daniel Erskine, Alan J. Thomas, John Paul Taylor, Michael A. Savage, Johannes Attems, Ian G. McKeith, Christopher M. Morris, Ahmad Khundakar

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    6 Citations (Scopus)
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    Abstract

    Objective Patients with dementia with Lewy bodies (DLB) often experience visual hallucinations, which are related to decreased quality of life for patients and increased caregiver distress. The pathologic changes that contribute to visual hallucinations are not known, but several hypotheses implicate deficient attentional processing. The superior colliculus has a role in visual attention and planning eye movements and has been directly implicated in several models of visual hallucinations. Therefore, the present study sought to identify neurodegenerative changes that may contribute to hallucinations in DLB. Methods Postmortem superior colliculus tissue from 13 comparison, 10 DLB, and 10 Alzheimer disease (AD) cases was evaluated using quantitative neuropathologic methods. Results α-Synuclein and tau deposition were more severe in deeper layers of the superior colliculus. DLB cases had neuronal density reductions in the stratum griseum intermedium, an important structure in directing attention toward visual targets. In contrast, neuronal density was reduced in all laminae of the superior colliculus in AD. Conclusion These findings suggest that regions involved in directing attention toward visual targets are subject to neurodegenerative changes in DLB. Considering several hypotheses of visual hallucinations implicating dysfunctional attention toward external stimuli, these findings may provide evidence of pathologic changes that contribute to the manifestation of visual hallucinations in DLB.

    Original languageEnglish
    Pages (from-to)595-604
    Number of pages10
    JournalAmerican Journal of Geriatric Psychiatry
    Volume25
    Issue number6
    Early online date10 Jan 2017
    DOIs
    Publication statusPublished - 1 Jun 2017

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