Detecting the Second Most Common Neurodegenerative Disease Before Symptoms

A research group has now shown that the disease can be detected before symptoms appear, using a spinal fluid test. 

Lewy body disease is an umbrella term for Parkinson’s disease and Lewy body dementia, it is the second most common neurodegenerative disease after Alzheimer’s disease. When movement difficulties are more dominant, the disease is called Parkinson’s disease, and when cognitive impairments are dominant, the term Lewy body dementia is used.

A research group has now shown that the disease can be detected before symptoms appear, using a spinal fluid test. 

“Lewy body disease is caused by the misfolding of the alpha-synuclein protein in the brain. When this happens, the protein clumps together and forms what are called Lewy bodies, which damage the nerve cells,” says Oskar Hansson, Professor of Neurology.

Until very recently, it was not possible to determine with certainty whether a person with movement difficulties or cognitive impairments had Lewy bodies in the brain until after their death. But now, with a spinal fluid test, it is possible to see if the person has the misfolded protein. Oskar Hansson’s research group involved over 1,100 individuals, none of whom initially showed any cognitive impairments or motor difficulties. However, it turned out that nearly ten percent had Lewy bodies in their brains according to the spinal fluid test. Therefore, it is possible to detect Lewy body disease even before the first symptoms appear.

An interesting finding was also that Lewy bodies are strongly associated with a reduced sense of smell even before other symptoms have developed. The sense of smell also deteriorates as the disease progresses. The correlation is so clear that it could be justified to screen individuals over 60 years of age with a smell test and then proceed with testing spinal fluid if one wants to detect Lewy body disease early, according to Oskar Hansson.

“Several drugs targeted at Lewy bodies are currently being developed, with the hope of slowing down the disease. Most likely, this type of medication has the best chance of being effective if administered early in the course of the disease. If symptom-free individuals with reduced sense of smell were identified, and the test for Lewy bodies was positive, they could participate in drug trials aimed at developing new medications that can halt the disease early,” says Oskar Hansson.


Corinne Quadalti, Sebastian Palmqvist, Sara Hall, Marcello Rossi, Angela Mammana, Shorena Janelidze, Sofia Dellavalle, Niklas Mattsson-Carlgren, Simone Baiardi, Erik Stomrud, Oskar Hansson, Piero Parchi. Clinical effects of Lewy body pathology in cognitively impaired individuals. Nature Medicine, 2023; DOI: 10.1038/s41591-023-02449-7

Lund University. “Lewy body disease can be detected before symptoms.” ScienceDaily. ScienceDaily, 18 July 2023. <>.

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Photo by: Robina Weermeijer