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Cognitive/behavioral neurologists increasingly recognize that demented patients with features of parkinsonism often have dementia with Lewy bodies (DLB), whereas movement disorder specialists identify cognitive impairment and dementia as a common nonmotor feature of Parkinson disease (PD). The article by Ballard et al.1 in this issue of Neurology examines the neurochemical and pathologic changes in these two Lewy body–related disorders, with an eye toward better understanding of their biology as well as the relationship between these two clinical entities.
Patients with both PD dementia (PDD) and DLB have Lewy body pathology in the nucleus basalis of Meynert, leading to cortical cholinergic deficits, which are greater than those seen in patients with Alzheimer disease (AD).2,3 These data suggest that patients with Lewy body–related dementias have the potential to benefit more from therapy with cholinesterase inhibitors than patients with AD. The study by Ballard et al. adds to what we know about cholinergic losses in PDD and DLB by examining a range of patients with earlier, later, and late development …
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