Diagnosis and Therapy for Lewy Body Dementia

2017 ◽  
Author(s):  
Bela R. Turk ◽  
Ali Fatemi
Keyword(s):  
Adverse Reaction ◽  
Parkinson Disease ◽  
Dementia With Lewy Bodies ◽  
Lewy Bodies ◽  
Lewy Body Dementia ◽  
The Elderly ◽  
Alpha Synuclein ◽  
Accurate Diagnosis ◽  
Degenerative Diseases ◽  
Severe Adverse Reaction

Almost undistinguished some 30 years ago, dementia with Lewy bodies is now shown to be the second most common neurodegenerative cause of dementia in the elderly. A host of neuroinflammatory mechanisms are attributed to Lewy bodies and their component alpha synuclein, a common pathology shared by Parkinson disease and Parkinson disease with dementia. Accurate diagnosis of patients is essential, as they show unique impairment patterns, which differ from other forms of dementia and show severe adverse reaction to neuroleptic medication, a common treatment in other degenerative diseases.

scholarly journals Slow Progressive Accumulation of Oligodendroglial Alpha-Synuclein (α-Syn) Pathology in Synthetic α-Syn Fibril-Induced Mouse Models of Synucleinopathy

2019 ◽  
Vol 78 (10) ◽  
pp. 877-890 ◽  
Author(s):  
Norihito Uemura ◽  
Maiko T Uemura ◽  
Angela Lo ◽  
Fares Bassil ◽  
Bin Zhang ◽  
...  
Keyword(s):  
White Matter ◽  
Multiple System Atrophy ◽  
Parkinson Disease ◽  
Mouse Models ◽  
Dementia With Lewy Bodies ◽  
Lewy Bodies ◽  
Alpha Synuclein ◽  
Wild Type ◽  
Time Points ◽  
Progressive Accumulation

Abstract Synucleinopathies are composed of Parkinson disease (PD), dementia with Lewy bodies (DLB), and multiple system atrophy (MSA). Alpha-synuclein (α-Syn) forms aggregates mainly in neurons in PD and DLB, while oligodendroglial α-Syn aggregates are characteristic of MSA. Recent studies have demonstrated that injections of synthetic α-Syn preformed fibrils (PFFs) into the brains of wild-type (WT) animals induce intraneuronal α-Syn aggregates and the subsequent interneuronal transmission of α-Syn aggregates. However, injections of α-Syn PFFs or even brain lysates of patients with MSA have not been reported to induce oligodendroglial α-Syn aggregates, raising questions about the pathogenesis of oligodendroglial α-Syn aggregates in MSA. Here, we report that WT mice injected with mouse α-Syn (m-α-Syn) PFFs develop neuronal α-Syn pathology after short postinjection (PI) intervals on the scale of weeks, while oligodendroglial α-Syn pathology emerges after longer PI intervals of several months. Abundant oligodendroglial α-Syn pathology in white matter at later time points is reminiscent of MSA. Furthermore, comparison between young and aged mice injected with m-α-Syn PFFs revealed that PI intervals rather than aging correlate with oligodendroglial α-Syn aggregation. These results provide novel insights into the pathological mechanisms of oligodendroglial α-Syn aggregation in MSA.

scholarly journals Cognitive fluctuations in Lewy body dementia: towards a pathophysiological framework

Brain ◽  
2019 ◽  
Vol 143 (1) ◽  
pp. 31-46 ◽  
Author(s):  
Elie Matar ◽  
James M Shine ◽  
Glenda M Halliday ◽  
Simon J G Lewis
Keyword(s):  
Lewy Body ◽  
Dementia With Lewy Bodies ◽  
Scientific Explanation ◽  
Lewy Bodies ◽  
Lewy Body Dementia ◽  
The Elderly ◽  
Diagnostic Feature ◽  
Accurate Identification ◽  
Therapeutic Trials ◽  
Cognitive Fluctuations

Abstract Fluctuating cognition is a complex and disabling symptom that is seen most frequently in the context of Lewy body dementias encompassing dementia with Lewy bodies and Parkinson’s disease dementia. In fact, since their description over three decades ago, cognitive fluctuations have remained a core diagnostic feature of dementia with Lewy bodies, the second most common dementia in the elderly. In the absence of reliable biomarkers for Lewy body pathology, the inclusion of such patients in therapeutic trials depends on the accurate identification of such core clinical features. Yet despite their diagnostic relevance, cognitive fluctuations remain poorly understood, in part due to the lack of a cohesive clinical and scientific explanation of the phenomenon itself. Motivated by this challenge, the present review examines the history, clinical phenomenology and assessment of cognitive fluctuations in the Lewy body dementias. Based on these data, the key neuropsychological, neurophysiological and neuroimaging correlates of cognitive fluctuations are described and integrated into a novel testable heuristic framework from which new insights may be gained.

Characterization of dementia with Lewy bodies (DLB) and mild cognitive impairment using the Lewy body dementia module (LBD‐MOD)

2021 ◽  
Author(s):  
James E. Galvin ◽  
Stephanie Chrisphonte ◽  
Iris Cohen ◽  
Keri K. Greenfield ◽  
Michael J. Kleiman ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Lewy Body ◽  
Dementia With Lewy Bodies ◽  
Lewy Bodies ◽  
Lewy Body Dementia

scholarly journals Levodopa-induced dyskinesia in dementia with Lewy bodies and Parkinson disease with dementia

2019 ◽  
Vol 10 (2) ◽  
pp. 156-161
Author(s):  
Pierpaolo Turcano ◽  
Cole D. Stang ◽  
James H. Bower ◽  
J. Eric Ahlskog ◽  
Bradley F. Boeve ◽  
...  
Keyword(s):  
Parkinson Disease ◽  
Dementia With Lewy Bodies ◽  
Lewy Bodies ◽  
Population Based ◽  
Olmsted County ◽  
Levodopa Dosage ◽  
Younger Age ◽  
Increased Risk ◽  
Incident Cohort ◽  
Median Interval

ObjectiveTo investigate the frequency of levodopa-induced dyskinesia in dementia with Lewy bodies (DLBs) and Parkinson disease with dementia (PDD) and compare these frequencies with patients with incident Parkinson disease (PD) through a population-based cohort study.MethodsWe identified all patients with DLB, PDD, and PD without dementia in a 1991–2010 population-based parkinsonism-incident cohort, in Olmsted County, Minnesota. We abstracted information about levodopa-induced dyskinesia. We compared patients with DLB and PDD with dyskinesia with patients with PD from the same cohort.ResultsLevodopa use and dyskinesia data were available for 141/143 (98.6%) patients with a diagnosis of either DLB or PDD; 87 (61.7%), treated with levodopa. Dyskinesia was documented in 12.6% (8 DLB and 3 PDD) of levodopa-treated patients. Among these patients, median parkinsonism diagnosis age was 74 years (range: 64–80 years); 63.6%, male. The median interval from levodopa initiation to dyskinesia onset was 2 years (range: 3 months–4 years); the median daily levodopa dosage was 600 mg (range: 50–1,600 mg). Dyskinesia severity led to levodopa adjustments in 5 patients, and all improved. Patients with dyskinesia were diagnosed with parkinsonism at a significantly younger age compared with patients without dyskinesia (p < 0.001). Levodopa dosage was unrelated to increased risk of dyskinesias among DLB and PDD. In contrast, 30.1% of levodopa-treated patients with PD developed dyskinesia. In age-, sex-, and levodopa dosage–adjusted models, Patients with DLB and PDD each had lower odds of developing dyskinesia than patients with PD (odds ratio = 0.42, 95% CI 0.21–0.88; p = 0.02).ConclusionsThe dyskinesia risk for levodopa-treated patients with DLB or PDD was substantially less than for levodopa-treated patients with PD.

ALPHA SYNUCLEIN IMMUNOREACTIVITY IN DEMENTIA WITH LEWY BODIES

1999 ◽  
Vol 58 (5) ◽  
pp. 553
Author(s):  
E Gómez-Tortosa ◽  
K L Newell ◽  
M C Irizarry ◽  
M Albert ◽  
J H Growdon ◽  
...  
Keyword(s):  
Dementia With Lewy Bodies ◽  
Lewy Bodies ◽  
Alpha Synuclein

[P1-243]: ALPHA-SYNUCLEIN SPECIES AS POTENTIAL CSF BIOMARKERS FOR DEMENTIA WITH LEWY BODIES

2017 ◽  
Vol 13 (7S_Part_7) ◽  
pp. P338-P338 ◽  
Author(s):  
Inger van Steenoven ◽  
Nour K. Majbour ◽  
Nishant N. Vaikath ◽  
Henk W. Berendse ◽  
Wiesje M. van der Flier ◽  
...  
Keyword(s):  
Dementia With Lewy Bodies ◽  
Lewy Bodies ◽  
Alpha Synuclein ◽  
Csf Biomarkers

Psychosocial support for people with dementia with Lewy bodies

2021 ◽  
Vol 23 (5) ◽  
pp. 1-8
Author(s):  
Alison Killen
Keyword(s):  
Dementia With Lewy Bodies ◽  
Psychosocial Support ◽  
Lewy Bodies ◽  
Lewy Body Dementia ◽  
Adverse Outcomes ◽  
Care Staff ◽  
The Core ◽  
People With Dementia ◽  
Age Related ◽  
Core Features

Background Lewy body dementia is the second most common form of age-related neurodegenerative dementia. It has two forms: dementia with Lewy bodies and Parkinson's disease dementia. Methods There are specific core symptoms associated with dementia with Lewy bodies. Optimum care requires awareness of the features associated with these, as well as appropriate support and management strategies, which are provided in this article. Results The core features of dementia with Lewy bodies are visual hallucinations, cognitive fluctuations, Parkinsonism and rapid eye movement sleep behaviour disorder. Appropriate psychosocial strategies includes psychoeducation, social support and environmental modification. Adoption of these approaches can reduce adverse outcomes. Conclusions The core features of dementia with Lewy bodies can significantly impair quality of life. Nursing and residential care staff are ideally placed to address this through the implementation of psychosocial strategies both directly, and through the provision of psychoeducation for family caregivers.

Movement Disorders 2: Parkinson’s Plus and Degenerative Diseases (DRAFT)

2018 ◽  
Author(s):  
Tamara Kaplan ◽  
Tracey Milligan
Keyword(s):  
Huntington's Disease ◽  
Progressive Supranuclear Palsy ◽  
Movement Disorders ◽  
Dementia With Lewy Bodies ◽  
Wilson’S Disease ◽  
Lewy Bodies ◽  
Corticobasal Degeneration ◽  
Degenerative Diseases ◽  
Multiple Systems ◽  
Multiple Systems Atrophy

The video in this chapter explores movement disorders, and focuses on Parkinson’s Plus and degenerative diseases. It outlines the features and pathology of dementia with lewy bodies (DLB), progressive supranuclear palsy (PSP), multiple systems atrophy (MSA) and corticobasal degeneration (CBD), as well as genetic movement disorders, Wilson’s disease, and Huntington’s disease.

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