NEOCORTICAL CHOLINERGIC ACTIVITIES DIFFERENTIATE LEWY BODY DEMENTIA FROM CLASSICAL ALZHEIMERS-DISEASE

ACTIVITY of the enzyme which synthesizes acetylcholine, choline acetyl transferase, was estimated in the neocortex of three series of control and demented cases. Clinically demented cases were divided into those with the classical neuropathological features of Alzheimer's disease (numerous neocortical plaques and tangles) and those with Lewy bodies in the brain stem and cortex (together with plaques and variable neuro fibrillary pathology). In the Lewy body cases neocortical choline acet yltransferase was consistently lower than in the classical Alzheimer-t ype cases. Two of the Lewy body cases with extremely low cholinergic a ctivity were responders in therapeutic trials of the cholinesterase in hibitor, tacrine, and the combined data suggest that cholinergic thera py may be particularly relevant to patients with Lewy body type dement ia.