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To the Editor:
Weisman et al.1 reported the validation of revised neuropathologic criteria for dementia with Lewy bodies (DLB) proposed by the Consortium for Dementia with Lewy Bodies.2 In their analysis, they incorrectly assess the application of the new neuropathologic criteria.
The new recommendations for neuropathologic diagnosis of DLB propose that the neuropathologic assessment should generate a probability statement about the likelihood that the pathology would be associated with the DLB clinical syndrome. The probability is positively related to the extent of Lewy body pathology (increasing from brainstem to limbic to diffuse Lewy body types) and negatively related to the severity of Alzheimer type pathology (decreasing from high to intermediate to low likelihood Alzheimer disease [AD]).
Evidence available at the time of the formulation of the criteria suggested that many cases in both the intermediate and high probability groups would have the DLB syndrome. In the report by Weisman et al., they classified cases of diffuse Lewy body disease and high likelihood AD (Braak stages V–VI) as “low probability DLB,” but the classification should be “intermediate probability DLB.”2
The frequency …
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