| DLB | Alpha-synuclein is the primary driver. Cortical involvement is early and prominent. Lewy bodies distributed diffusely across cortex and limbic system simultaneously[@mckeith2024]. |
| PD | Alpha-synuclein follows a brainstem-to-cortical gradient. Motor symptoms precede cortical involvement by years[@aarsland2021]. |
| AD | Distinct dual proteinopathy — amyloid-beta plaques (extracellular) and tau neurofibrillary tangles (intracellular). Amyloid accumulation precedes tau spreading by years. |
| DLB/AD | 50-60% of DLB cases have moderate-to-severe AD co-pathology. The presence of amyloid-beta and tau modifies the clinical phenotype and predicts faster decline. |
| PD/AD | Many PD patients develop sufficient amyloid and tau pathology to meet criteria for concomitant AD. |
| Databases | OMIMOrphanetClinicalTrialsPubMed |
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