{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T01:30:50Z","timestamp":1762997450737,"version":"build-2065373602"},"reference-count":28,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2019,7,4]],"date-time":"2019-07-04T00:00:00Z","timestamp":1562198400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Background: Cerebral amyloid angiopathy (CAA) is characterized by deposition of amyloid in small\/medium size brain vessels, and may coexist with Alzheimer\u2019s disease or dementia with Lewy bodies (DLB). We describe a patient with a clinical diagnosis of DLB and imaging\/biochemical characteristics suggestive of mixed small vessel disease (both CAA and non-amyloid microangiopathy). Methods: Clinical evaluation according to recent diagnostic criteria, magnetic resonance imaging, dopamine-transporter scan (DAT-scan) and cerebrospinal fluid (CSF) analysis for dementia biomarkers were all performed. Results: The patient is a 71-year-old male, fulfilling criteria for probable DLB, with a positive DAT-scan, but with multiple microbleeds in a cortical-subcortical location suggestive of CAA, some microbleeds in deep brain nuclei suggestive of non-amyloid microangiopathy and abnormal levels of only amyloid-beta (A\u03b242) in CSF. Conclusion: Coexistent mixed vascular and neurodegenerative disorders are frequent in older subjects with dementia and each one of the underlying pathologies may contribute to, or modify the clinical presentation.<\/jats:p>","DOI":"10.3390\/brainsci9070159","type":"journal-article","created":{"date-parts":[[2019,7,4]],"date-time":"2019-07-04T11:13:18Z","timestamp":1562238798000},"page":"159","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Mixed Small Vessel Disease in a Patient with Dementia with Lewy Bodies"],"prefix":"10.3390","volume":"9","author":[{"given":"George P.","family":"Paraskevas","sequence":"first","affiliation":[{"name":"1st Department of Neurology, Cognitive and Movement Disorders clinic and Unit of Neurochemistry and Biological Markers, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, 10679 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7432-5009","authenticated-orcid":false,"given":"Vasilios C.","family":"Constantinides","sequence":"additional","affiliation":[{"name":"1st Department of Neurology, Cognitive and Movement Disorders clinic and Unit of Neurochemistry and Biological Markers, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, 10679 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2197-2434","authenticated-orcid":false,"given":"Efstratios-Stylianos","family":"Pyrgelis","sequence":"additional","affiliation":[{"name":"1st Department of Neurology, Cognitive and Movement Disorders clinic and Unit of Neurochemistry and Biological Markers, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, 10679 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisabeth","family":"Kapaki","sequence":"additional","affiliation":[{"name":"1st Department of Neurology, Cognitive and Movement Disorders clinic and Unit of Neurochemistry and Biological Markers, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, 10679 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2019,7,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"17","DOI":"10.5853\/jos.2015.17.1.17","article-title":"Cerebral amyloid angiopathy: Emerging concepts","volume":"17","author":"Yamada","year":"2015","journal-title":"J. Stroke"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1893","DOI":"10.2169\/internalmedicine.53.2962","article-title":"The spectrum of cerebral amyloid angiopathy-related disorders","volume":"53","author":"Yamada","year":"2014","journal-title":"Intern. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"64","DOI":"10.3389\/fneur.2012.00064","article-title":"Predicting cerebral amyloid angiopathy-related intracerebral hemorrhages and other cerebrovascular disorders in Alzheimer\u2019s disease","volume":"3","author":"Yamada","year":"2012","journal-title":"Front. Neurol."},{"doi-asserted-by":"crossref","unstructured":"Attems, J., and Jellinger, K.A. (2014). The overlap between vascular disease and Alzheimer\u2019s disease\u2014Lessons from pathology. BMC Med., 12.","key":"ref_4","DOI":"10.1186\/s12916-014-0206-2"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.jns.2007.01.045","article-title":"Neuropathological evaluation of mixed dementia","volume":"257","author":"Jellinger","year":"2007","journal-title":"J. Neurol. Sci."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1212\/WNL.0000000000004058","article-title":"Diagnosis and management of dementia with Lewy bodies: Fourth consensus report of the DLB Consortium","volume":"89","author":"McKeith","year":"2017","journal-title":"Neurology"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"683","DOI":"10.2217\/bmm.10.90","article-title":"Quantification of alpha-synuclein in cerebrospinal fluid as a biomarker candidate: review of the literature and considerations for future studies","volume":"4","author":"Mollenhauer","year":"2010","journal-title":"Biomark. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1007\/s00401-008-0347-5","article-title":"Prevalence and impact of vascular and Alzheimer pathologies in Lewy body disease","volume":"115","author":"Jellinger","year":"2008","journal-title":"Acta Neuropathol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1016\/j.parkreldis.2014.02.012","article-title":"Arizona Parkinson\u2019s Disease Consortium. Concomitant pathologies among a spectrum of parkinsonian disorders","volume":"20","author":"Dugger","year":"2014","journal-title":"Parkinsonism Relat. Disord."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1097\/WAD.0000000000000034","article-title":"Diagnostic criteria for vascular cognitive disorders: A VASCOG statement","volume":"28","author":"Sachdev","year":"2014","journal-title":"Alzheimer Dis. Assoc. Disord."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"419","DOI":"10.2217\/bmm.12.46","article-title":"Recommendations to standardize preanalytical confounding factors in Alzheimer\u2019s and Parkinson\u2019s disease cerebrospinal fluid biomarkers: An update","volume":"6","author":"Mollenhauer","year":"2012","journal-title":"Biomark. Med."},{"unstructured":"Bourbouli, M., Kapaki, E., Petropoulou, O., and Paraskevas, G.P. (2018). Improved Performance of CSF Dementia Biomarker Measurements Over Time: The Effect of Quality Control and Harmonization Programs. Biomark. Applic., 2018.","key":"ref_12"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.3233\/JAD-160494","article-title":"Cerebrospinal Fluid Biomarkers as a Diagnostic Tool of the Underlying Pathology of Primary Progressive Aphasia","volume":"55","author":"Paraskevas","year":"2017","journal-title":"J. Alzheimers Dis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/0022-3956(75)90026-6","article-title":"Mini-Mental State: A practical method for grading the cognitive state of patients for the clinician","volume":"12","author":"Folstein","year":"1975","journal-title":"J. Psychiatr. Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1346","DOI":"10.1212\/WNL.0b013e3181dad605","article-title":"Prevalence of superficial siderosis in patients with cerebral amyloid angiopathy","volume":"74","author":"Linn","year":"2010","journal-title":"Neurology"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1161\/STROKEAHA.117.016990","article-title":"Diagnosis of Cerebral Amyloid Angiopathy: Evolution of the Boston Criteria","volume":"49","author":"Greenberg","year":"2018","journal-title":"Stroke"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e774","DOI":"10.1212\/WNL.0000000000006953","article-title":"Microangiopathy underlying mixed-location intracerebral hemorrhages\/microbleeds: A PiB-PET study","volume":"92","author":"Tsai","year":"2019","journal-title":"Neurology"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e119","DOI":"10.1212\/WNL.0000000000004797","article-title":"Mixed-location cerebral hemorrhage\/microbleeds: Underlying microangiopathy and recurrence risk","volume":"90","author":"Pasi","year":"2018","journal-title":"Neurology"},{"key":"ref_19","first-page":"7247325","article-title":"The Impact of Cerebral Amyloid Angiopathy in Various Neurodegenerative Dementia Syndromes: A Neuropathological Study","volume":"2019","year":"2019","journal-title":"Neurol. Res. Int."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1094","DOI":"10.1016\/j.clineuro.2012.11.005","article-title":"Prevalence of cerebrovascular lesions in patients with Lewy body dementia: A neuropathological study","volume":"115","author":"Deramecourt","year":"2013","journal-title":"Clin. Neurol. Neurosurg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1016\/j.jalz.2016.09.008","article-title":"Recommendations for CSF AD biomarkers in the diagnostic evaluation of dementia","volume":"13","author":"Simonsen","year":"2017","journal-title":"Alzheimer\u2019s Dement."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1417","DOI":"10.3233\/JAD-170803","article-title":"Update on Vascular Cognitive Impairment Associated with Subcortical Small-Vessel Disease","volume":"62","author":"Wallin","year":"2018","journal-title":"J. Alzheimers Dis."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1186\/s13195-014-0072-3","article-title":"Biomarkers in biological fluids for dementia with Lewy bodies","volume":"6","author":"Schade","year":"2014","journal-title":"Alzheimers Res. Ther."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1930","DOI":"10.1212\/WNL.0000000000002175","article-title":"Cerebral amyloid angiopathy and cognitive outcomes in community-based older persons","volume":"85","author":"Boyle","year":"2015","journal-title":"Neurology"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2010","DOI":"10.1161\/STROKEAHA.116.012999","article-title":"Cerebral Amyloid Angiopathy Is Associated With Executive Dysfunction and Mild Cognitive Impairment","volume":"47","author":"Case","year":"2016","journal-title":"Stroke"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2497","DOI":"10.1161\/STROKEAHA.116.014166","article-title":"Strictly Lobar Cerebral Microbleeds Are Associated With Cognitive Impairment","volume":"47","author":"Chung","year":"2016","journal-title":"Stroke"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1177\/0004867414525843","article-title":"Cerebral amyloid angiopathy presenting with neuropsychiatric symptoms","volume":"48","author":"Gleason","year":"2014","journal-title":"Aust. N. Z. J. Psychiatry"},{"key":"ref_28","first-page":"1","article-title":"Characteristics of patients with amyloid-beta-related cerebral amyloid angiopathy presenting in a dementia clinic","volume":"1","author":"Paraskevas","year":"2018","journal-title":"Int. J. Alzhei. Parkin. Dis."}],"container-title":["Brain Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3425\/9\/7\/159\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:02:37Z","timestamp":1760187757000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3425\/9\/7\/159"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,7,4]]},"references-count":28,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2019,7]]}},"alternative-id":["brainsci9070159"],"URL":"https:\/\/doi.org\/10.3390\/brainsci9070159","relation":{},"ISSN":["2076-3425"],"issn-type":[{"type":"electronic","value":"2076-3425"}],"subject":[],"published":{"date-parts":[[2019,7,4]]}}}