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Fortschr Neurol Psychiatr 2018; 86(S 01): S43-S47
DOI: 10.1055/a-0696-6249
Workshop
© Georg Thieme Verlag KG Stuttgart · New York

Demenz mit Lewy-Körpern

Dementia with Lewy bodies
Richard Dodel
1   Lehrstuhl für Geriatrie, Universitätsklinikum Essen,Geriatriezentrum Haus Berge, Contilia Group, Essen
,
Jiri Koschel
2   Parkinsonklinik Ortenau, Wolfach
,
Stefan Lorenzl
3   Institut für Pflegewissenschaft und -praxis, Paracelsus Medizinische Privatuniversität, Strubergasse 21, 5020, Salzburg, Österreich
,
Johannes Levin
4   Neurologische Klinik und Poliklinik, Ludwig-Maximilians-Universität München & Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), München
,
Thilo van Eimeren
5   Multimodal Neuroimaging Group, Klinik für Nuklearmedizin, Universitätsklinik Köln; Deutsches Zentrum für Neurodegenerative Erkrankungen e. V. (DZNE) Bonn-Köln
,
Günter Höglinger
6   Klinik für Neurologie, Klinikum rechts der Isar, Technische Universität München und Lehrstuhl für Translationale Neurodegeneration, Deutsches Zentrum für Neurodegenerative Erkrankungen e. V. (DZNE) München
› Author Affiliations
Further Information

Publication History

eingereicht 08 June 2018

akzeptiert 07 August 2018

Publication Date:
21 September 2018 (online)

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Zusammenfassung

Die Demenz mit Lewy-Körpern ist histopathologisch durch die Ablagerung von α-Synuclein in Einschlusskörpern gekennzeichnet. Für die klinische Diagnose wird eine fortschreitende Demenz sowie das Auftreten von Fluktuationen der Kognition, früh im Krankheitsverlauf auftretende visuelle Halluzinationen, REM-Schlafverhaltensstörungen sowie die Symptome eines Parkinson-Syndroms zugrunde gelegt. Anhand der 2017 erschienenen neuen Kriterien soll eine bessere Trennung von anderen neurodegenerativen Erkrankungen mit Demenz möglich sein. Therapiekonzepte beinhalten die Behandlung der motorischen sowie der kognitiven Leistungseinbuße sowie die psychologischen und Verhaltenssymptome. Gegenwärtig stehen nur wenige Studien für dieses Krankheitsbild zur Verfügung, so dass Evidenz-basierte Therapieansätze nur bedingt möglich sind.

Abstract

Dementia with Lewy bodies is characterized histopathologically by the deposition of α-synuclein in inclusion bodies. Clinical diagnosis is based on progressive cognitive deficits, cognitive fluctuations, early visual hallucinations, REM sleep disorders and symptoms of Parkinsonism. On the basis of the new criteria published in 2017, better differentiation from other neurodegenerative diseases with dementia should be possible. Therapy concepts include treatment of loss of motor and cognitive performance as well as psychological and behavioral symptoms. At present, only a few studies are available on this clinical picture so that evidence-based therapy approaches are only possible to a limited extent.

Schlüsselwörter

Demenz mit Lewy Körper - Alzheimer - Bildgebung

Key words

Lewy body dementia - Alzheimer Disease - Imaging
 

  • Literatur

  • 1 Bohnen NI, Koeppe RA, Minoshima S. et al. Cerebral glucose metabolic features of Parkinson disease and incident dementia: longitudinal study. J Nucl Med 2011; 52: 848-855 .
    CrossrefPubMedGoogle Scholar
  • 2 Bonelli SB, Ransmayr G, Steffelbauer M, Lukas T, Lampl C, Deibl M. L-dopa responsiveness in dementia with Lewy bodies, Parkinson disease with and without dementia. Neurology 2004; 63: 376-378 .
    CrossrefPubMed
  • 3 Geser F, Wenning GK, Poewe W, McKeith I. How to diagnose dementia with Lewy bodies: state of the art. Mov Disord 2005; 20 Suppl 12 : S11-20 .
    CrossrefPubMed
  • 4 Gomperts SN, Locascio JJ, Makaretz SJ. et al. Tau Positron Emission Tomographic Imaging in the Lewy Body Diseases. JAMA Neurol 2016; 73: 1334-1341 .
    CrossrefPubMedGoogle Scholar
  • 5 Herholz K, Ebmeier K. Clinical amyloid imaging in Alzheimer’s disease. Lancet Neurol 2011; 10: 667-670 .
    CrossrefPubMed
  • 6 Hogan DB, Fiest KM, Roberts JI. et al. The Prevalence and Incidence of Dementia with Lewy Bodies: a Systematic Review. Can J Neurol Sci 2016; 43 Suppl 1 : S83-95 .
    PubMedGoogle Scholar
  • 7 Iannaccone S, Cerami C, Alessio M. et al. In vivo microglia activation in very early dementia with Lewy bodies, comparison with Parkinson’s disease. Parkinsonism Relat Disord 2013; 19: 47-52 .
    CrossrefPubMedGoogle Scholar
  • 8 Kantarci K, Lowe VJ, Boeve BF. et al. AV-1451 tau and beta-amyloid positron emission tomography imaging in dementia with Lewy bodies. Ann Neurol 2017; 81: 58-67 .
    CrossrefPubMedGoogle Scholar
  • 9 Karantzoulis S, Galvin JE. Distinguishing Alzheimer’s disease from other major forms of dementia. Expert Rev Neurother 2011; 11: 1579-1591 .
    CrossrefPubMed
  • 10 Klein JC, Eggers C, Kalbe E. et al. Neurotransmitter changes in dementia with Lewy bodies and Parkinson disease dementia in vivo. Neurology 2010; 74: 885-892 .
    CrossrefPubMedGoogle Scholar
  • 11 Langbaum JB, Chen K, Lee W. et al. Categorical and correlational analyses of baseline fluorodeoxyglucose positron emission tomography images from the Alzheimer’s Disease Neuroimaging Initiative (ADNI). Neuroimage 2009; 45: 1107-1116 .
    CrossrefPubMedGoogle Scholar
  • 12 Levin J, Kurz A, Arzberger T, Giese A, Hoglinger GU. The Differential Diagnosis and Treatment of Atypical Parkinsonism. Dtsch Arztebl Int 2016; 113: 61-69 .
    PubMed
  • 13 Lim SM, Katsifis A, Villemagne VL. et al. The 18F-FDG PET cingulate island sign and comparison to 123I-beta-CIT SPECT for diagnosis of dementia with Lewy bodies. J Nucl Med 2009; 50: 1638-1645 .
    CrossrefPubMedGoogle Scholar
  • 14 Mayer WD. G. S3-Leitlinie Demenzen. www.dgn.org , 2016 .
    PubMed
  • 15 McKeith I, O’Brien J, Walker Z. et al. Sensitivity and specificity of dopamine transporter imaging with 123I-FP-CIT SPECT in dementia with Lewy bodies: a phase III, multicentre study. Lancet Neurol 2007; 6: 305-313 .
    CrossrefPubMedGoogle Scholar
  • 16 McKeith IG, Boeve BF, Dickson DW. et al. Diagnosis and management of dementia with Lewy bodies: Fourth consensus report of the DLB Consortium. Neurology 2017; 89: 88-100 .
    CrossrefPubMedGoogle Scholar
  • 17 Minoshima S, Foster NL, Sima AA, Frey KA, Albin RL, Kuhl DE. Alzheimer’s disease versus dementia with Lewy bodies: cerebral metabolic distinction with autopsy confirmation. Ann Neurol 2001; 50: 358-365 .
    CrossrefPubMed
  • 18 Nelson PT, Jicha GA, Kryscio RJ. et al. Low sensitivity in clinical diagnoses of dementia with Lewy bodies. J Neurol 2010; 257: 359-366 .
    CrossrefPubMedGoogle Scholar
  • 19 Postuma RB, Berg D, Stern M. et al. MDS clinical diagnostic criteria for Parkinson’s disease. Mov Disord 2015; 30: 1591-1601 .
    CrossrefPubMedGoogle Scholar
  • 20 Rowe CC, Ng S, Ackermann U. et al. Imaging beta-amyloid burden in aging and dementia. Neurology 2007; 68: 1718-1725 .
    CrossrefPubMedGoogle Scholar
  • 21 Schade S, Mollenhauer B. Biomarkers in biological fluids for dementia with Lewy bodies. Alzheimers Res Ther 2014; 6: 72 .
    CrossrefPubMed
  • 22 Shams S, Fallmar D, Schwarz S. et al. MRI of the Swallow Tail Sign: A Useful Marker in the Diagnosis of Lewy Body Dementia? AJNR Am J Neuroradiol 2017; 38: 1737-1741 .
    CrossrefPubMed
  • 23 van Eimeren T, Bischof GN, Drzezga A. Is Tau Imaging More Than Just Upside-Down (18)F-FDG Imaging? J Nucl Med 2017; 58: 1357-1359 .
    CrossrefPubMed
  • 24 Varrone A, Asenbaum S, Vander Borght T. et al. EANM procedure guidelines for PET brain imaging using [18F]FDG, version 2. Eur J Nucl Med Mol Imaging 2009; 36: 2103-2110 .
    CrossrefPubMedGoogle Scholar
  • 25 Wang HF, Yu JT, Tang SW. et al. Efficacy and safety of cholinesterase inhibitors and memantine in cognitive impairment in Parkinson’s disease, Parkinson’s disease dementia, and dementia with Lewy bodies: systematic review with meta-analysis and trial sequential analysis. J Neurol Neurosurg Psychiatry 2015; 86: 135-143 .
    CrossrefPubMedGoogle Scholar
  • 26 Watson R, Colloby SJ, Blamire AM, O’Brien JT. Assessment of regional gray matter loss in dementia with Lewy bodies: a surface-based MRI analysis. Am J Geriatr Psychiatry 2015; 23: 38-46 .
    CrossrefPubMed