Lewy bodies are abnormal aggregates of protein that develop inside nerve cells in Parkinson's disease (PD), Lewy body dementia, and some other disorders. They are identified under the microscope when histology is performed on the brain.
Lewy bodies appear as spherical masses that displace other cell components. Lewy bodies may be found in the brainstem (within the substantia nigra) or within the cortex. A classical Lewy body is an eosinophilic cytoplasmic inclusion consisting of a dense core surrounded by a halo of 10-nm-wide radiating fibrils, the primary structural component of which is alpha-synuclein. Cortical Lewy bodies are also composed of alpha-synuclein fibrils, but are less defined and lack halos. In histopathology, cortical Lewy bodies are a distinguishing feature for dementia with Lewy bodies (DLB), but may occasionally be seen in ballooned neurons characteristic of Pick's disease and corticobasal degeneration, as well as in patients with other tauopathies. They are also seen in cases of multiple system atrophy, particularly the parkinsonian variant.
In 1910 Fritz Heinrich Lewy studied in Berlin to get his doctorate. Lewy was the first doctor who noticed that some unusual proteins in the brain make some people act and think differently, but as of that time, scientists had not been able to figure out what the exact purpose of this protein actually is to the brain. His finding became known as Lewy bodies, as published in the Handbook of Neurology in 1912.
According to the Journal of the History of the Neurosciences, Dr. Lewy became interested in studying more about the brain (neurology), because of the discovery that Alois Alzheimer made in 1906. The article mentions that the third reported case of Alzheimer's disease had histological structures that happened to be similar to Lewy body histology slides, but the contribution was not given to Lewy's finding.
A Lewy body is composed of the protein alpha-synuclein associated with other proteins, such as ubiquitin, neurofilament protein, and alpha B crystallin. Tau proteins may also be present, and Lewy bodies may occasionally be surrounded by neurofibrillary tangles. Lewy bodies and NFTs can occasionally exist in the same neuron, particularly in the amygdala.
Lewy neurites are abnormal neurites in diseased neurons, containing granular material and abnormal α-synuclein filaments similar to those found in Lewy bodies. Like Lewy bodies, Lewy neurites are a feature of α-synucleinopathies such as dementia with Lewy bodies, Parkinson's disease, and multiple system atrophy. They are also found in the CA2-3 region of the hippocampus in Alzheimer's disease.
Notable people who suffered from Lewy body dementia include:
- Actor Robin Williams
- Actress Estelle Getty
- Music industry icon Casey Kasem
- Athlete Stan Mikita
- Artist Don Featherstone, creator of the iconic lawn flamingo
- Former NBA head coach Jerry Sloan
- In the premiere episode of Boss, Dr. Ella Harris tells Chicago Mayor Tom Kane he has Lewy bodies, and his progressing symptoms are shown in each episode.
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