Objective: The aim of the study is to report Parkinson’s disease (PD) case series with co-occurening amyotrophic lateral sclerosis (ALS) and neuropathologically characterize one case.
Background: There are several reports showing parkinsonism accompying the ALS patients. Some extrapyramidal symptoms are revealed in 7-15% of ALS cases. It is a very rare entity with lack of precise pathological descriptions in the literature.
Method: We included four patients into analysis (two males and two females). The clinical diagnosis of PD and ALS was made by experienced neurologists . Brain MRI, psychological examination and electromyography with nerve conduction studies were performed. Post-mortem neuropathological examination with immunohistochemical staining was performed in 76 year old woman.
Results: The median age of onset was between 60 and 69 years old. The diagnosis of PD proceed the diagnosis of ALS in all cases and was reported between 3 and 20 years later. Three patients were diagnosed with dementia and one preserve the normal cognitive functioning. The brain MRI revealed vascular lesions in all patients and brain atrophy in three patients. NCS revealed mainly axonal changes in motor nerves in all cases whereas electromyography showed neurogenic deinervation in all cases with acute reinnervation and fasciculations in two cases. The neuropathological study revealed neuronal loss with astrocyte proliferation in brain cortex, basal ganglia, brain stem nuclei and spinal cord anterior horns, mild demyelination in brain and spinal cord white matter. Lewy bodies and TDP-43-positive nuclear and glial inclusions were revealed which is typical for neuropathological diagnosis of PD and ALS.
Conclusion: The diagnosis of the different neurodegenerative disorders may be challenging. Growing evidence suggests that neurodegenerative diseases may present with overlapping symptoms and share a common pathological basis.
To cite this abstract in AMA style:
L. Milanowski, A. Salinska, A. Acewicz, M. Grzegorczyk, S. Tarka, S. Szlufik, T. Wierzba-Bobrowicz, D. Koziorowski. Parkinson’s disease overlapping with other neurodegeneration-case series with neuropathological description. [abstract]. Mov Disord. 2025; 40 (suppl 1). https://www.mdsabstracts.org/abstract/parkinsons-disease-overlapping-with-other-neurodegeneration-case-series-with-neuropathological-description/. Accessed November 20, 2025.« Back to 2025 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/parkinsons-disease-overlapping-with-other-neurodegeneration-case-series-with-neuropathological-description/