The Lewy body dementias

2020 ◽  
pp. 495-512
Author(s):  
Arvid Rongve ◽  
Dag Aarsland
Keyword(s):  
Dementia With Lewy Bodies ◽  
Clinical Symptoms ◽  
Imaging Techniques ◽  
Lewy Bodies ◽  
Epidemiological Data ◽  
Antipsychotic Medications ◽  
Esterase Inhibitors ◽  
Staging Systems ◽  
The Brain ◽  
Clinical Diagnostic Criteria

Dementia with Lewy bodies (DLB) and Parkinson’s disease dementia (PDD) belong to the α‎-synucleinopathies, a family of diseases pathologically characterized by aggregation of α‎-synuclein in Lewy bodies in the brain. This chapter presents the epidemiological data for both conditions including new data on MCI. It reviews clinical diagnostic criteria and considers the different neuropathology staging systems for DLB and PDD and the most important genetic findings. It describes biomarkers in DLB and PDD with particular focus on imaging techniques like CIT-SPECT and MRI. It presents in detail important clinical symptoms in both conditions and discusses the most important clinical differential diagnoses. Finally, it examines pharmacological and non- pharmacological treatment of different symptoms in both conditions, with particular emphasis on the choline esterase inhibitors and antipsychotic medications, and presents new data on memantine.

Dementia with Lewy bodies and Parkinson’s disease dementia

2013 ◽  
Author(s):  
Arvid Rongve ◽  
Dag Aarsland
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Dementia With Lewy Bodies ◽  
Clinical Symptoms ◽  
Imaging Techniques ◽  
Lewy Bodies ◽  
Epidemiological Data ◽  
Parkinson’S Disease Dementia ◽  
Esterase Inhibitors ◽  
Staging Systems

Dementia with Lewy bodies and Parkinson’s disease dementia belong to the α-synucleinopathies, a family of diseases pathologically characterized by aggregation of α-synuclein in Lewy bodies in the brain. In this chapter we present the epidemiological data for both conditions including new data on MCI. Clinical diagnostic criteria are reviewed and the different neuropathology staging systems for DLB and PDD and the most important genetic findings are considered. Biomarkers in DLB and PDD with particular focus on imaging techniques like CIT-SPECT and MRI are described. Important clinical symptoms in both conditions are presented in detail and the most important clinical differential diagnoses are discussed. Pharmacological and non- pharmacological treatment of different symptoms in both conditions are discussed with particular emphasis on the choline esterase inhibitors and antipsychotic medications.New data on memantine are presented.

Prodromal Dementia With Lewy Bodies: Evolution of Symptoms and Predictors of Dementia Onset

2021 ◽  
pp. 089198872110235
Author(s):  
Kathryn A. Wyman-Chick ◽  
Lauren R. O’Keefe ◽  
Daniel Weintraub ◽  
Melissa J. Armstrong ◽  
Michael Rosenbloom ◽  
...  
Keyword(s):  
Clinical Features ◽  
Dementia With Lewy Bodies ◽  
Clinical Symptoms ◽  
Neuropsychiatric Symptoms ◽  
Lewy Bodies ◽  
Rem Sleep Behavior Disorder ◽  
Data Set ◽  
Wide Range ◽  
Prodromal Dementia ◽  
Dementia Onset

Background: Research criteria for prodromal dementia with Lewy bodies (DLB) were published in 2020, but little is known regarding prodromal DLB in clinical settings. Methods: We identified non-demented participants without neurodegenerative disease from the National Alzheimer’s Coordinating Center Uniform Data Set who converted to DLB at a subsequent visit. Prevalence of neuropsychiatric and motor symptoms were examined up to 5 years prior to DLB diagnosis. Results: The sample included 116 participants clinically diagnosed with DLB and 348 age and sex-matched (1:3) Healthy Controls. Motor slowing was present in approximately 70% of participants 3 years prior to DLB diagnosis. In the prodromal phase, 50% of DLB participants demonstrated gait disorder, 70% had rigidity, 20% endorsed visual hallucinations, and over 50% of participants endorsed REM sleep behavior disorder. Apathy, depression, and anxiety were common prodromal neuropsychiatric symptoms. The presence of 1+ core clinical features of DLB in combination with apathy, depression, or anxiety resulted in the greatest AUC (0.815; 95% CI: 0.767, 0.865) for distinguishing HC from prodromal DLB 1 year prior to diagnosis. The presence of 2+ core clinical features was also accurate in differentiating between groups (AUC = 0.806; 95% CI: 0.756, 0.855). Conclusion: A wide range of motor, neuropsychiatric and other core clinical symptoms are common in prodromal DLB. A combination of core clinical features, neuropsychiatric symptoms and cognitive impairment can accurately differentiate DLB from normal aging prior to dementia onset.

scholarly journals Magnetic Resonance Spectroscopy in the Diagnosis of Dementia with Lewy Bodies

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Radoslaw Magierski ◽  
Tomasz Sobow
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Magnetic Resonance ◽  
Magnetic Resonance Spectroscopy ◽  
Dementia With Lewy Bodies ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Lewy Bodies ◽  
Resonance Spectroscopy ◽  
Diagnosis Of Dementia

Dementia with Lewy bodies (DLB) is considered to be the second most frequent primary degenerative dementing illness after Alzheimer’s disease (AD). DLB, together with Parkinson’s disease (PD), Parkinson’s disease with dementia (PDD) belong toα-synucleinopathies—a group of neurodegenerative diseases associated with pathological accumulation of theα-synuclein protein. Dementia due to PD and DLB shares clinical symptoms and neuropsychological profiles. Moreover, the core features and additional clinical signs and symptoms for these two very similar diseases are largely the same. Neuroimaging seems to be a promising method in differential diagnosis of dementia studies. The development of imaging methods or other objective measures to supplement clinical criteria for DLB is needed and a method which would accurately facilitate diagnosis of DLB prior to death is still being searched. Proton magnetic resonance spectroscopy (1H-MRS) provides a noninvasive method of assessing anin vivobiochemistry of brain tissue. This review summarizes the main results obtained from the application of neuroimaging techniques in DLB cases focusing on1H-MRS.

scholarly journals Abnormalities of resting-state EEG in patients with prodromal and overt dementia with Lewy bodies: Relation to clinical symptoms

2020 ◽  
Vol 131 (11) ◽  
pp. 2716-2731
Author(s):  
Maria Teresa Pascarelli ◽  
Claudio Del Percio ◽  
Maria Francesca De Pandis ◽  
Raffaele Ferri ◽  
Roberta Lizio ◽  
...  
Keyword(s):  
Resting State ◽  
Dementia With Lewy Bodies ◽  
Clinical Symptoms ◽  
Lewy Bodies

Profiles of matrix metalloproteinases and their inhibitors in plasma of patients with dementia

2008 ◽  
Vol 20 (1) ◽  
pp. 67-76 ◽  
Author(s):  
Stefan Lorenzl ◽  
Katharina Büerger ◽  
Harald Hampel ◽  
M. Flint Beal
Keyword(s):  
Matrix Metalloproteinases ◽  
Brain Tissue ◽  
Dementia With Lewy Bodies ◽  
Constitutive Expression ◽  
Lewy Bodies ◽  
Postmortem Brain ◽  
Plasma Samples ◽  
Postmortem Brain Tissue ◽  
The Brain ◽  
Circulating Levels

ABSTRACTBackground: Matrix metalloproteinases (MMPs) are elevated in the brain tissue of patients with dementia and may play a role in the pathophysiology of dementia. MMP-9 and tissue inhibitors of MMPs (TIMPs) are elevated in postmortem brain tissue of patients with Alzheimer's disease (AD). In a previous study we showed that circulating levels of MMP-9 are elevated in AD patients. The aim of the present study was to examine circulating levels of MMP-1, MMP-2, MMP-9, TIMP-1 and TIMP-2 in the plasma of patients with mild cognitive impairment (MCI), AD, vascular dementia (VaD), dementia with Lewy bodies (DLB) and frontotemporal dementia (FTD), to determine, whether plasma profiles of MMPs and TIMPs differ in various types of dementia.Methods: Gelatinolytic activity (MMP-2 and MMP-9) was measured in all plasma samples by zymography. Levels of MMP-2, MMP-9, MMP-1 as well as TIMP-1 and TIMP-2 were measured by ELISA.Results: We found constitutive expression of MMP-1, -2 and -9 as well as TIMP-1 and -2 in all the samples investigated. As shown previously, MMP-9 was significantly elevated in the plasma of AD patients (p = 0.004) as compared to controls and MCI patients. Plasma levels of TIMP-1 were significantly lower in VD samples as compared to all other groups. Levels of TIMP-2 were significantly lower in patients with FTD as compared to AD, VaD and MCI patients. There were no significant changes of MMP-1 and MMP-2 levels in the samples.Conclusion: These findings suggest that circulating levels of MMP-9, TIMP-1 and TIMP-2 and changes in the MMP/TIMP balance in plasma differ in various types of dementia.

scholarly journals α-Synuclein-mediated neurodegeneration in Dementia with Lewy bodies: the pathobiology of a paradox

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Christopher Simon ◽  
Tomoko Soga ◽  
Hirotaka James Okano ◽  
Ishwar Parhar
Keyword(s):  
Dementia With Lewy Bodies ◽  
Lewy Bodies ◽  
Conceptual Frameworks ◽  
Dependent Cell ◽  
Bona Fide ◽  
The Brain

AbstractDementia with Lewy bodies (DLB) is epitomized by the pathognomonic manifestation of α-synuclein-laden Lewy bodies within selectively vulnerable neurons in the brain. By virtue of prion-like inheritance, the α-synuclein protein inexorably undergoes extensive conformational metamorphoses and culminate in the form of fibrillar polymorphs, instigating calamitous damage to the brain’s neuropsychological networks. This epiphenomenon is nebulous, however, by lingering uncertainty over the quasi “pathogenic” behavior of α-synuclein conformers in DLB pathobiology. Despite numerous attempts, a monolithic “α-synuclein” paradigm that is able to untangle the enigma enshrouding the clinicopathological spectrum of DLB has failed to emanate. In this article, we review conceptual frameworks of α-synuclein dependent cell-autonomous and non-autonomous mechanisms that are likely to facilitate the transneuronal spread of degeneration through the neuraxis. In particular, we describe how the progressive demise of susceptible neurons may evolve from cellular derangements perpetrated by α-synuclein misfolding and aggregation. Where pertinent, we show how these bona fide mechanisms may mutually accentuate α-synuclein-mediated neurodegeneration in the DLB brain.

Cholinergic and Monoaminergic Correlates of Clinical Symptoms in Dementia with Lewy Bodies

2002 ◽  
pp. 491-496
Author(s):  
Elaine K. Perry ◽  
Margaret A. Piggott ◽  
Mary Johnson ◽  
Clive G. Ballard ◽  
Ian G. McKeith ◽  
...  
Keyword(s):  
Dementia With Lewy Bodies ◽  
Clinical Symptoms ◽  
Lewy Bodies
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