We investigated whether cerebrovascular disease contributes to neurodegeneration and clinical phenotype in dementia with Lewy bodies (DLB). Regional cortical thickness and subcortical gray matter volumes were estimated from structural magnetic resonance imaging (MRI) in 165 DLB patients. Cortical and subcortical infarcts were recorded and white matter hyperintensities (WMHs) were assessed. Subcortical only infarcts were more frequent (13.3%) than cortical only infarcts (3.1%) or both subcortical and cortical infarcts (2.4%). Infarcts, irrespective of type, were associated with WMHs. A higher WMH volume was associated with thinner orbitofrontal, retrosplenial, and posterior cingulate cortices, smaller thalamus and pallidum, and larger caudate volume. A higher WMH volume was associated with the presence of visual hallucinations and lower global cognitive performance, and tended to be associated with the absence of probable rapid eye movement sleep behavior disorder. Presence of infarcts was associated with the absence of parkinsonism. We conclude that cerebrovascular disease is associated with gray matter neurodegeneration in patients with probable DLB, which may have implications for the multifactorial treatment of probable DLB.

Centre for Age Related Medicine Stavanger University Hospital Stavanger Norway; Institute of Psychiatry Psychology and Neuroscience King's College London London UK

Centre for Age Related Medicine Stavanger University Hospital Stavanger Norway; Stavanger Medical Imaging Laboratory Department of Radiology Stavanger University Hospital Stavanger Norway; Department of Electrical Engineering and Computer Science University of Stavanger Stavanger Norway

Day Hospital of Geriatrics Memory Resource and Research Centre ICONE Strasbourg France

Department of Health Sciences Mayo Clinic Rochester MN USA

Department of Neurology and Alzheimer Center VU University Medical Center Amsterdam Netherlands

Department of Neurology Charles University 2nd Faculty of Medicine Motol University Hospital Prague Czech Republic; International Clinical Research Center St Anne's University Hospital Brno Brno Czech Republic

Department of Neurology Mayo Clinic Jacksonville FL USA

Department of Neurology Mayo Clinic Rochester MN USA

Department of Psychiatry and Psychology Mayo Clinic Jacksonville FL

Department of Psychiatry and Psychology Mayo Clinic Rochester MN USA

Department of Radiology and Nuclear Medicine VU University Medical Center Amsterdam Netherlands; Queen Square Institute of Neurology University College London London UK

Department of Radiology Mayo Clinic Rochester MN USA

Department of Radiology Mayo Clinic Rochester MN USA; Department of Information Technology Mayo Clinic Rochester MN USA

Department of Radiology Mayo Clinic Rochester MN USA; Department of Neurology Charles University 2nd Faculty of Medicine Motol University Hospital Prague Czech Republic

Division of Clinical Geriatrics Center for Alzheimer Research Department of Neurobiology Care Sciences and Society Karolinska Institutet Stockholm Sweden; Department of Neuroimaging Centre for Neuroimaging Sciences Institute of Psychiatry Psychology and Neuroscience King's College London London UK

Division of Clinical Geriatrics Center for Alzheimer Research Department of Neurobiology Care Sciences and Society Karolinska Institutet Stockholm Sweden; Department of Radiology Mayo Clinic Rochester MN USA

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Sex differences in brain atrophy in dementia with Lewy bodies

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