Cortical microstructural abnormalities in dementia with Lewy bodies and their associations with Alzheimer’s disease copathologies

Abstract Dementia with Lewy bodies (DLB) frequently coexists with Alzheimer’s disease pathology, yet the pattern of cortical microstructural injury and its relationship with amyloid, tau, and cerebrovascular pathologies remains unclear. We applied neurite orientation dispersion and density imaging (...

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Main Authors: Elijah Mak, Robert I. Reid, Scott A. Przybelski, Angela J. Fought, Timothy G. Lesnick, Christopher G. Schwarz, Matthew L. Senjem, Sheelakumari Raghavan, Prashanthi Vemuri, Clifford R. Jack, Hoon Ki Min, Manoj K. Jain, Toji Miyagawa, Leah K. Forsberg, Julie A. Fields, Rodolfo Savica, Jonathan Graff-Radford, David T. Jones, Hugo Botha, Erik K. St. Louis, David S. Knopman, Vijay K. Ramanan, Dennis W. Dickson, Neill R. Graff-Radford, Gregory S. Day, Tanis J. Ferman, Ronald C. Petersen, Val J. Lowe, Bradley F. Boeve, John T. O’Brien, Kejal Kantarci
Format: Article
Language:English
Published: Nature Portfolio 2025-05-01
Series:npj Parkinson's Disease
Online Access:https://doi.org/10.1038/s41531-025-00944-x
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author Elijah Mak
Robert I. Reid
Scott A. Przybelski
Angela J. Fought
Timothy G. Lesnick
Christopher G. Schwarz
Matthew L. Senjem
Sheelakumari Raghavan
Prashanthi Vemuri
Clifford R. Jack
Hoon Ki Min
Manoj K. Jain
Toji Miyagawa
Leah K. Forsberg
Julie A. Fields
Rodolfo Savica
Jonathan Graff-Radford
David T. Jones
Hugo Botha
Erik K. St. Louis
David S. Knopman
Vijay K. Ramanan
Dennis W. Dickson
Neill R. Graff-Radford
Gregory S. Day
Tanis J. Ferman
Ronald C. Petersen
Val J. Lowe
Bradley F. Boeve
John T. O’Brien
Kejal Kantarci
author_facet Elijah Mak
Robert I. Reid
Scott A. Przybelski
Angela J. Fought
Timothy G. Lesnick
Christopher G. Schwarz
Matthew L. Senjem
Sheelakumari Raghavan
Prashanthi Vemuri
Clifford R. Jack
Hoon Ki Min
Manoj K. Jain
Toji Miyagawa
Leah K. Forsberg
Julie A. Fields
Rodolfo Savica
Jonathan Graff-Radford
David T. Jones
Hugo Botha
Erik K. St. Louis
David S. Knopman
Vijay K. Ramanan
Dennis W. Dickson
Neill R. Graff-Radford
Gregory S. Day
Tanis J. Ferman
Ronald C. Petersen
Val J. Lowe
Bradley F. Boeve
John T. O’Brien
Kejal Kantarci
author_sort Elijah Mak
collection DOAJ
description Abstract Dementia with Lewy bodies (DLB) frequently coexists with Alzheimer’s disease pathology, yet the pattern of cortical microstructural injury and its relationship with amyloid, tau, and cerebrovascular pathologies remains unclear. We applied neurite orientation dispersion and density imaging (NODDI) to assess cortical microstructural integrity in 57 individuals within the DLB spectrum and 57 age- and sex-matched cognitively unimpaired controls by quantifying mean diffusivity (MD), tissue-weighted neurite density index (tNDI), orientation dispersion index (ODI), and free water fraction (FWF). Amyloid and tau levels were measured using PiB and Flortaucipir PET imaging. Compared to controls, DLB exhibited increased MD and FWF, reduced tNDI across multiple regions, and focal ODI reductions in the occipital cortex. Structural equation modeling revealed that APOE genotype influenced amyloid levels, which elevated tau, leading to microstructural injury. These findings highlight the role of AD pathology in DLB neurodegeneration, advocating for multi-target therapeutic approaches addressing both AD and DLB-specific pathologies.
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spelling doaj-art-a8a2fe62253e4715b5474d05a5ad19ec2025-08-20T03:04:26ZengNature Portfolionpj Parkinson's Disease2373-80572025-05-0111111510.1038/s41531-025-00944-xCortical microstructural abnormalities in dementia with Lewy bodies and their associations with Alzheimer’s disease copathologiesElijah Mak0Robert I. Reid1Scott A. Przybelski2Angela J. Fought3Timothy G. Lesnick4Christopher G. Schwarz5Matthew L. Senjem6Sheelakumari Raghavan7Prashanthi Vemuri8Clifford R. Jack9Hoon Ki Min10Manoj K. Jain11Toji Miyagawa12Leah K. Forsberg13Julie A. Fields14Rodolfo Savica15Jonathan Graff-Radford16David T. Jones17Hugo Botha18Erik K. St. Louis19David S. Knopman20Vijay K. Ramanan21Dennis W. Dickson22Neill R. Graff-Radford23Gregory S. Day24Tanis J. Ferman25Ronald C. Petersen26Val J. Lowe27Bradley F. Boeve28John T. O’Brien29Kejal Kantarci30Department of Radiology, Mayo ClinicDepartment of Radiology, Mayo ClinicDepartment of Quantitative Health Sciences, Mayo ClinicDepartment of Quantitative Health Sciences, Mayo ClinicDepartment of Quantitative Health Sciences, Mayo ClinicDepartment of Radiology, Mayo ClinicDepartment of Radiology, Mayo ClinicDepartment of Radiology, Mayo ClinicDepartment of Radiology, Mayo ClinicDepartment of Radiology, Mayo ClinicDepartment of Radiology, Mayo ClinicDepartment of Radiology, Mayo ClinicDepartment of Neurology, Mayo ClinicDepartment of Neurology, Mayo ClinicDepartment of Psychiatry and Psychology, Mayo ClinicDepartment of Neurology, Mayo ClinicDepartment of Neurology, Mayo ClinicDepartment of Neurology, Mayo ClinicDepartment of Neurology, Mayo ClinicDepartment of Neurology, Mayo ClinicDepartment of Neurology, Mayo ClinicDepartment of Neurology, Mayo ClinicLaboratory of Medicine and Pathology, Mayo Clinic in FloridaDepartment of Neurology, Mayo Clinic in FloridaDepartment of Neurology, Mayo Clinic in FloridaDepartment of Psychiatry and Psychology, Mayo Clinic in FloridaDepartment of Quantitative Health Sciences, Mayo ClinicDepartment of Radiology, Mayo ClinicDepartment of Neurology, Mayo ClinicDepartment of Psychiatry, University of CambridgeDepartment of Radiology, Mayo ClinicAbstract Dementia with Lewy bodies (DLB) frequently coexists with Alzheimer’s disease pathology, yet the pattern of cortical microstructural injury and its relationship with amyloid, tau, and cerebrovascular pathologies remains unclear. We applied neurite orientation dispersion and density imaging (NODDI) to assess cortical microstructural integrity in 57 individuals within the DLB spectrum and 57 age- and sex-matched cognitively unimpaired controls by quantifying mean diffusivity (MD), tissue-weighted neurite density index (tNDI), orientation dispersion index (ODI), and free water fraction (FWF). Amyloid and tau levels were measured using PiB and Flortaucipir PET imaging. Compared to controls, DLB exhibited increased MD and FWF, reduced tNDI across multiple regions, and focal ODI reductions in the occipital cortex. Structural equation modeling revealed that APOE genotype influenced amyloid levels, which elevated tau, leading to microstructural injury. These findings highlight the role of AD pathology in DLB neurodegeneration, advocating for multi-target therapeutic approaches addressing both AD and DLB-specific pathologies.https://doi.org/10.1038/s41531-025-00944-x
spellingShingle Elijah Mak
Robert I. Reid
Scott A. Przybelski
Angela J. Fought
Timothy G. Lesnick
Christopher G. Schwarz
Matthew L. Senjem
Sheelakumari Raghavan
Prashanthi Vemuri
Clifford R. Jack
Hoon Ki Min
Manoj K. Jain
Toji Miyagawa
Leah K. Forsberg
Julie A. Fields
Rodolfo Savica
Jonathan Graff-Radford
David T. Jones
Hugo Botha
Erik K. St. Louis
David S. Knopman
Vijay K. Ramanan
Dennis W. Dickson
Neill R. Graff-Radford
Gregory S. Day
Tanis J. Ferman
Ronald C. Petersen
Val J. Lowe
Bradley F. Boeve
John T. O’Brien
Kejal Kantarci
Cortical microstructural abnormalities in dementia with Lewy bodies and their associations with Alzheimer’s disease copathologies
npj Parkinson's Disease
title Cortical microstructural abnormalities in dementia with Lewy bodies and their associations with Alzheimer’s disease copathologies
title_full Cortical microstructural abnormalities in dementia with Lewy bodies and their associations with Alzheimer’s disease copathologies
title_fullStr Cortical microstructural abnormalities in dementia with Lewy bodies and their associations with Alzheimer’s disease copathologies
title_full_unstemmed Cortical microstructural abnormalities in dementia with Lewy bodies and their associations with Alzheimer’s disease copathologies
title_short Cortical microstructural abnormalities in dementia with Lewy bodies and their associations with Alzheimer’s disease copathologies
title_sort cortical microstructural abnormalities in dementia with lewy bodies and their associations with alzheimer s disease copathologies
url https://doi.org/10.1038/s41531-025-00944-x
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