This case and our other similar cases prompted us to propose the terms “Lewy body disease” in 1980 and “diffuse Lewy body disease” in 1984. We also reported in 1990 that DLBD was classified into two forms: a pure form and a common form. Based on these studies the term “dementia with Lewy bodies (DLB)” was proposed in 1996. Since 1980, we have insisted that DLB, Parkinson selleck compound disease (PD), and PD with dementia (PDD) should be understood within the spectrum of Lewy body disease. This insistence has been recently

accepted by the International Workshop and the International Working Group on DLB and PDD in 2005 and in 2006, respectively. In 1976, we reported1 the first autopsied case characterized by: (i) clinical features of progressive dementia and parkinsonism; and (ii) neuropathological findings showing both numerous cortical and Alvelestat mouse brain stem Lewy bodies and Alzheimer pathology. In 1978, we also reported2 the detailed morphological and histochemical

features of cortical Lewy bodies, based on three similar cases, including our first case. Furthermore, we reported3 two similar German autopsied cases. This was the first case report of diffuse Lewy body disease (DLBD)4 not only in Germany but also in Europe. In 1984, we proposed4 the term DLBD based on our 11 autopsied cases. Although some similar cases have been reported in Japan since our reports, DLBD was thought to be a rare dementing illness. In fact, only Okazaki et al.5 and Forno et al.6 had reported similar cases in 1961 and 1978, respectively. Since our proposal of the term DLBD, many DLBD cases have been reported in Europe and America. Based on our DLBD studies, the new term “dementia with Lewy bodies (DLB)” was proposed at the first International Workshop in 1995.7 The clinical

and pathological diagnostic criteria were published in Neurology in 1996.8 Since then, DLB has been able to be clinically diagnosed, and has been reported to be the second most frequent dementia following Alzheimer’s Rho disease (AD). Cortical Lewy bodies had been overlooked in classical staining preparations prior to our reports.1–4 However, recently it has become possible to easily detect cortical Lewy bodies and Lewy neurites by alpha-synuclein immunostaining. In this paper, we re-examined our first DLBD case, using various immunohistochemical methods. As both the clinical data and classical neuropathological findings were described in detail in our previous paper,1 only the summary of this case is presented here. A 56-year-old woman demonstrated mild neck tremor and forgetfulness. Dementia progressed gradually. She was admitted to a psychiatric hospital because of profound dementia and psychomotor restlessness. Thereafter, muscle rigidity and apathy also developed. She died of ileus at the age of 65 years. The brain weighed 1130 g.