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Neuronal Loss and Α-Synuclein Pathology in the Superior Colliculus and Its Relationship to Visual Hallucinations in Dementia with Lewy Bodies

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



This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).


OBJECTIVE: Patients with dementia with Lewy bodies (DLB) often experience visual hallucinations, which are related to decreased quality of life for patients and increased caregiver distress. The pathologic changes that contribute to visual hallucinations are not known, but several hypotheses implicate deficient attentional processing. The superior colliculus has a role in visual attention and planning eye movements and has been directly implicated in several models of visual hallucinations. Therefore, the present study sought to identify neurodegenerative changes that may contribute to hallucinations in DLB.METHODS: Postmortem superior colliculus tissue from 13 comparison, 10 DLB, and 10 Alzheimer disease (AD) cases was evaluated using quantitative neuropathologic methods.RESULTS: α-Synuclein and tau deposition were more severe in deeper layers of the superior colliculus. DLB cases had neuronal density reductions in the stratum griseum intermedium, an important structure in directing attention toward visual targets. In contrast, neuronal density was reduced in all laminae of the superior colliculus in AD.CONCLUSION: These findings suggest that regions involved in directing attention toward visual targets are subject to neurodegenerative changes in DLB. Considering several hypotheses of visual hallucinations implicating dysfunctional attention toward external stimuli, these findings may provide evidence of pathologic changes that contribute to the manifestation of visual hallucinations in DLB.

Publication metadata

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

Publication type: Article

Publication status: Published

Journal: The American Journal of Geriatric Psychiatry

Year: 2017

Volume: 25

Issue: 6

Pages: 595-604

Print publication date: 01/06/2017

Online publication date: 10/01/2017

Acceptance date: 06/01/2017

Date deposited: 21/03/2017

ISSN (print): 1064-7481

ISSN (electronic): 1545-7214

Publisher: Elsevier


DOI: 10.1016/j.jagp.2017.01.005

PubMed id: 28190674

Notes: Layer-specific superior colliculus neurodegeneration may contribute to visual hallucinations in DLB


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