Cerebrovascular disease, neurodegeneration, and clinical phenotype in dementia with Lewy bodies

Daniel Ferreira, Zuzana Nedelska, Jonathan Graff-Radford, Scott A. Przybelski, Timothy G. Lesnick, Christopher G. Schwarz, Hugo Botha, Matthew L. Senjem, Julie A. Fields, David S. Knopman, Rodolfo Savica, Tanis J. Ferman, Neill R. Graff-Radford, Val J. Lowe, Clifford R. Jack, Ronald C. Petersen, Afina W. Lemstra, Marleen van de Beek, Frederik Barkhof, Frederic BlancPaulo Loureiro de Sousa, Nathalie Philippi, Benjamin Cretin, Catherine Demuynck, Jakub Hort, Ketil Oppedal, Bradley F. Boeve, Dag Aarsland, Eric Westman, Kejal Kantarci*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


We investigated whether cerebrovascular disease contributes to neurodegeneration and clinical phenotype in dementia with Lewy bodies (DLB). Regional cortical thickness and subcortical gray matter volumes were estimated from structural magnetic resonance imaging (MRI) in 165 DLB patients. Cortical and subcortical infarcts were recorded and white matter hyperintensities (WMHs) were assessed. Subcortical only infarcts were more frequent (13.3%) than cortical only infarcts (3.1%) or both subcortical and cortical infarcts (2.4%). Infarcts, irrespective of type, were associated with WMHs. A higher WMH volume was associated with thinner orbitofrontal, retrosplenial, and posterior cingulate cortices, smaller thalamus and pallidum, and larger caudate volume. A higher WMH volume was associated with the presence of visual hallucinations and lower global cognitive performance, and tended to be associated with the absence of probable rapid eye movement sleep behavior disorder. Presence of infarcts was associated with the absence of parkinsonism. We conclude that cerebrovascular disease is associated with gray matter neurodegeneration in patients with probable DLB, which may have implications for the multifactorial treatment of probable DLB.
Original languageEnglish
Pages (from-to)252-261
Number of pages10
JournalNeurobiology of Aging
Early online date14 May 2021
Publication statusPublished - 1 Sep 2021

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