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Clinical diagnoses include Parkinson\u2019s disease (PD), dementia with Lewy bodies, or pure autonomic failure. All types of LBD are accompanied by non-motor symptoms (NMSs) including gastrointestinal dysfunctions such as constipation. Its relationship to Lewy body-related \u03b1-synucleinopathy (Lewy pathology) of the enteric nervous system (ENS) is attracting attention because it can precede the motor symptoms. To clarify the role of ENS Lewy pathology in disease progression, we performed a clinicopathological study using the Brain Bank for Aging Research in Japan. Five-hundred and eighteen cases were enrolled in the study. Lewy pathology of the CNS and PNS, including the lower esophagus as a representative of the ENS, was examined via autopsy findings. Results showed that one-third of older people (178 cases, 34%) exhibited Lewy pathology, of which 78 cases (43.8%) exhibited the pathology in the esophagus. In the esophageal wall, Auerbach\u2019s plexus (41.6%) was most susceptible to the pathology, followed by the adventitia (33.1%) and Meissner\u2019s plexus (14.6%). Lewy pathology of the esophagus was significantly associated with autonomic failures such as constipation (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) and among PNS regions, correlated the most with LBD progression (<jats:italic>r<\/jats:italic>\u2009=\u20090.95, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). These findings suggest that the propagation of esophageal Lewy pathology is a predictive factor of LBD.<\/jats:p>","DOI":"10.1007\/s00401-020-02233-8","type":"journal-article","created":{"date-parts":[[2020,11,5]],"date-time":"2020-11-05T02:02:48Z","timestamp":1604541768000},"page":"25-37","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":82,"title":["Lewy pathology of the esophagus correlates with the progression of Lewy body disease: a Japanese cohort study of autopsy cases"],"prefix":"10.1007","volume":"141","author":[{"given":"Zen-ichi","family":"Tanei","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuko","family":"Saito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinji","family":"Ito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoyasu","family":"Matsubara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsuko","family":"Motoda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikihiro","family":"Yamazaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiro","family":"Sakashita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ito","family":"Kawakami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masako","family":"Ikemura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinya","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renpei","family":"Sengoku","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomio","family":"Arai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeo","family":"Murayama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,11,5]]},"reference":[{"key":"2233_CR1","doi-asserted-by":"publisher","first-page":"456","DOI":"10.1212\/wnl.57.3.456","volume":"57","author":"RD Abbott","year":"2001","unstructured":"Abbott RD, Petrovitch H, White LR, Masaki KH, Tanner CM, Curb JD et al (2001) Frequency of bowel movements and the future risk of Parkinson\u2019s disease. 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The study was approved by the institutional ethics review committee of the Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was obtained from all individual participants or their relatives.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}