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Specific patterns of neuronal loss in the pulvinar nucleus in dementia with Lewy bodies

Lookup NU author(s): Dr Daniel ErskineORCiD, Professor Alan ThomasORCiD, Professor Johannes Attems, Professor John-Paul TaylorORCiD, Professor Ian McKeith, Dr Christopher Morris, Dr Ahmad Khundakar


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Background Dementia with Lewy bodies patients experience visual attentional deficits, leading to a potential vulnerability to visual hallucinations. The pulvinar has a putative role in visual attention and is thought to modulate visual system functioning based on attentional demands. The pulvinar is thought to play an important role in hallucinations but has not been neuropathologically examined in dementia with Lewy bodies. Objective The present study investigated whether neuropathological or morphometric changes occur in the pulvinar nucleus in dementia with Lewy bodies cases that may contribute to visual hallucinations. Methods Post-mortem pulvinar tissue was acquired from eight dementia with Lewy bodies, eight Alzheimer’s disease and eight control cases and analyzed using stereological and quantitative neuropathological techniques. Results Lewy body pathology was found in all pulvinar sub-regions in dementia with Lewy bodies cases. However, neuronal loss was specifically found in the lateral pulvinar of dementia with Lewy bodies cases compared to control cases. Significant reductions in lateral pulvinar neuron number were also found in Alzheimer’s disease cases compared to controls, but these changes were not as marked as those observed in dementia with Lewy bodies cases. Conclusions The lateral pulvinar is thought to modulate visual cortical activity based on attentional demands, thus contributing to visual attentional functioning. As alterations to visual attentional function have been postulated to contribute a vulnerability to hallucination, the present results suggest neuropathological changes in visual components of the pulvinar that may contribute to attentional deficits and promote the manifestation of visual hallucinations in dementia with Lewy bodies.

Publication metadata

Author(s): Erskine D, Thomas AJ, Attems J, Taylor JP, McKeith IG, Morris CM, Khundakar AA

Publication type: Article

Publication status: Published

Journal: Movement Disorders

Year: 2017

Volume: 32

Issue: 3

Pages: 414-422

Print publication date: 01/03/2017

Online publication date: 06/01/2017

Acceptance date: 31/10/2016

ISSN (print): 0885-3185

ISSN (electronic): 1531-8257

Publisher: John Wiley & Sons, Inc.


DOI: 10.1002/mds.26887


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