Neurology® Podcast Body-First Lewy Body Disease Observed in Postmortem Tissue from Prediagnostic Individuals
May 15, 2025
Dr. Per Borghammer, a physician researcher from Aarhus University, dives into groundbreaking insights on Lewy body disease. He discusses the crucial distinction between brain-first and body-first subtypes, highlighting newly identified parasympathetic and sympathetic variations. Borghammer explores how these classifications impact symptom development, proving vital for precision medicine. He also addresses the challenges of diagnosing preclinical stages of Parkinson's, emphasizing the importance of analyzing non-brain tissues to improve early detection.
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Brain-First vs Body-First Lewy Disease
- Lewy body disease can be divided into brain-first and body-first subtypes with distinct spreading patterns.
- Brain-first spreads top-down from olfactory bulb; body-first spreads bottom-up from the gut via autonomic nerves.
Two Body-First Subtypes Identified
- The body-first form of Lewy body disease has two subtypes: parasympathetic predominant and sympathetic predominant.
- These subtypes differ by neuropathology spread mainly via the vagus nerve or sympathetic connectome respectively.
Unique Japanese Postmortem Data
- The study utilized a large, unique Japanese postmortem data set with 173 cases having Lewy pathology.
- The data showed both brain and peripheral organ involvement, crucial for understanding early-stage Lewy body disease.