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The neuropathological findings associated with this mutation have thus far been varied but are most often associated with Lewy body (LB) pathology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>Describe a case of clinical Parkinson's disease with levodopa responsiveness found to have LRRK2 mutations and the absence of Lewy bodies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>We present an 89\u2010year\u2010old man with a 10\u2010year history of slowly progressive parkinsonism suspected to be secondary to Parkinson's disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Neuropathological evaluation revealed nigral degeneration without Lewy bodies or Lewy neurites, but there were frequent tau\u2010immunopositive neurites and astrocytes in the putamen and substantia nigra, neocortical glial tau positive astrocytes associated with aging\u2010related tau astrogliopathy (ARTAG), as well as neurofibrillary tangles, beta amyloid plaques, and amyloid angiopathy typical of advanced Alzheimer's disease. G2019S LRRK2 homozygous mutations were found.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This case illustrates that levodopa\u2010responsive clinical PD caused by G2019S LRRK2 mutations can occur without Lewy bodies.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mdc3.14068","type":"journal-article","created":{"date-parts":[[2024,5,16]],"date-time":"2024-05-16T23:48:22Z","timestamp":1715903302000},"page":"874-878","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Parkinson's Disease Associated with <scp>G2019S LRRK2<\/scp> Mutations without Lewy Body Pathology"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4167-9489","authenticated-orcid":false,"given":"Lauren M.","family":"Jackson","sequence":"first","affiliation":[{"name":"Department of Neurology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan K.","family":"Woodruff","sequence":"additional","affiliation":[{"name":"Department of Neurology Mayo Clinic  Scottsdale Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8460-7421","authenticated-orcid":false,"given":"Cecilia","family":"Tremblay","sequence":"additional","affiliation":[{"name":"Department of Neuropathology Banner Sun Health Research Institute  Sun City Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holly A.","family":"Shill","sequence":"additional","affiliation":[{"name":"Barrow Neurological Institute  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3296-6128","authenticated-orcid":false,"given":"Thomas G.","family":"Beach","sequence":"additional","affiliation":[{"name":"Department of Neuropathology Banner Sun Health Research Institute  Sun City Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geidy E.","family":"Serrano","sequence":"additional","affiliation":[{"name":"Department of Neuropathology Banner Sun Health Research Institute  Sun City Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1045-2743","authenticated-orcid":false,"given":"Charles H.","family":"Adler","sequence":"additional","affiliation":[{"name":"Department of Neurology Mayo Clinic  Scottsdale Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,5,16]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/neup.12189"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1159\/000109764"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000167552.79769.b3"},{"key":"e_1_2_6_5_1","first-page":"415","article-title":"A common LRRK2 mutation in idiopathic 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