The number of Lewy bodies in certain regions of the brain can be counted using anti-ubiquitin immunostains. The count can help distinguish Lewy body dementia from Alzheimer's disease.


NOTE: While the power of magnification and field of view were reported, the type of microscope was not. The field of view reported for a 40x objective by Samuel et al was 0.10 square mm. The field of view for many microscopes with a 40x objective is around 0.20 square mm or greater. They may have been using more powerful eyepieces.


Cortical sections examined based on predilection for Lewy bodies:

(1) midbrain

(2) cingulated gyrus

(3) superior temporal (often the area with highest prevalence of Lewy bodies)

(4) inferior parietal


The tissue was formalin fixed, paraffin embedded and sectioned at 10 microns. Immunostaining was done with immunoperoxidase technique using antibodies to ubiquitin.


In each region the number of Lewy bodies in 5 fields were counted using a 40x objective (stated field of view 0.1 square mm) and the counts averaged.


It was important to distinguish Lewy bodies from globose neurofibrillary tangles (NFTs) which can resemble each other in the preparations.



Lewy Body

Globose NFT

appearance with affected neurons

round, nonfibrillary, intracellular, displace the nucleus peripherally

round, fibrillary, intracellular

cortical cell layer where found

5 and 6

3, 4 and 5

staining with anti-tau immunostains


strongly positive


Hansen et al reported Lewy bodies per square mm.

Samuel et al reported Lewy bodies per 0.1 square mm.


number of Lewy bodies in 1 square mm =

= 10 * (number seen in 0.1 square mm)


number of Lewy bodies in 1 square mm =

= (number of Lewy bodies counted in field area) / (field area in square mm)


Lewy Body Count in 1 square mm

Data from Samuel et al

> 16

Lewy body variant

8 to 16

probably Lewy body variant

< 8

probably Alzheimer's disease

after Figure 1, page 46


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