MDS Abstracts

Abstracts from the International Congress of Parkinson’s and Movement Disorders.

MENU 
  • Home
  • Meetings Archive
    • 2024 International Congress
    • 2023 International Congress
    • 2022 International Congress
    • MDS Virtual Congress 2021
    • MDS Virtual Congress 2020
    • 2019 International Congress
    • 2018 International Congress
    • 2017 International Congress
    • 2016 International Congress
  • Keyword Index
  • Resources
  • Advanced Search

New Neuropathological Staging System for Lewy Body Disease

J. Toledo, L. Walker, J. Trojanowski, I. Mckeith, J. Attems (Houston, TX, USA)

Meeting: 2019 International Congress

Abstract Number: 1178

Keywords: Alpha-synuclein, Dementia with Lewy bodies (DLB), Lewy bodies

Session Information

Date: Tuesday, September 24, 2019

Session Title: Classification of Movement Disorders

Session Time: 1:45pm-3:15pm

Location: Les Muses Terrace, Level 3

Objective: Present the validation of the new proposed novel staging system (NSS) for Lewy body disease and compare it against the previously proposed staging systems.

Background: Several staging criteria have been previously proposed for the neuropathological classification of cases with deposition of α-synuclein in the form of Lewy related pathology (LRP). The previously developed neuropathological staging criteria, like the 2005 Newcastle-McKeith Dementia with Lew bodies (DLB) criteria and the 2003 Braak LRP staging system, led to a large number of cases not being classified when applied to a varied sample of neuropathological cases with LRP and to some cases fitting more than one category in some instances.

Method: We uploaded scanned slide images for 34 cases to an online server. Nine regions were included and a panel of 18 international experts semi-quantitatively rated each of the slides and classified each case based on the Newcastle-McKeith DLB 2005 third report criteria, the Braak 2003 criteria, the Leverenz 2008 criteria, the Unified Staging System criteria and the new proposed NSS to these cases. Multiple inter-rater agreement was estimated Cronbach α and confidence intervals were bootstrapped. In addition, we retrospectively applied the criteria to a sample of 204 cases with LRP to evaluate the percentage of cases not classified by each of the systems in a large representative sample of cases from a clinical brain bank.

Results: Inter-rater agreement for semi-quantitative scores for each of the evaluated areas mostly fell between the 0.70 and 0.80 range. Median percentage of unclassified cases in the prospective sample was 0% for the NSS, whereas for the other staging systems it ranged between 3-26%. In the retrospective analysis all cases were also classified by the NSS, whereas for the other staging systems up to 58.3% of the cases were not classified. The NSS also achieved one of the highest inter-rater agreements for the classification into the different staging systems.

Conclusion: The new criteria classified showed overall the best combination of classification of cases and inter-rater agreement of all the available LRP classification systems. They are also based on a dichotomous evaluation of the pathology, which simplifies the rating procedure. All these characteristics make the proposed system an easy implementable and reliable system to evaluate LRP in future studies.

To cite this abstract in AMA style:

J. Toledo, L. Walker, J. Trojanowski, I. Mckeith, J. Attems. New Neuropathological Staging System for Lewy Body Disease [abstract]. Mov Disord. 2019; 34 (suppl 2). https://www.mdsabstracts.org/abstract/new-neuropathological-staging-system-for-lewy-body-disease/. Accessed May 18, 2025.
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

« Back to 2019 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/new-neuropathological-staging-system-for-lewy-body-disease/

Most Viewed Abstracts

  • This Week
  • This Month
  • All Time
  • An Apparent Cluster of Parkinson's Disease (PD) in a Golf Community
  • Covid vaccine induced parkinsonism and cognitive dysfunction
  • What is the appropriate sleep position for Parkinson's disease patients with orthostatic hypotension in the morning?
  • The hardest symptoms that bother patients with Parkinson's disease
  • Life expectancy with and without Parkinson’s disease in the general population
  • What is the appropriate sleep position for Parkinson's disease patients with orthostatic hypotension in the morning?
  • Increased Risks of Botulinum Toxin Injection in Patients with Hypermobility Ehlers Danlos Syndrome: A Case Series
  • Insulin dependent diabetes and hand tremor
  • Improvement in hand tremor following carpal tunnel release surgery
  • Impact of expiratory muscle strength training (EMST) on phonatory performance in Parkinson's patients
  • Help & Support
  • About Us
  • Cookies & Privacy
  • Wiley Job Network
  • Terms & Conditions
  • Advertisers & Agents
Copyright © 2025 International Parkinson and Movement Disorder Society. All Rights Reserved.
Wiley