PDF herunterladen
Semin Neurol 2013; 33(04): 330-335
DOI: 10.1055/s-0033-1359315
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Dementia with Lewy Bodies

Jennifer Rose V. Molano
1   Department of Neurology and Rehabilitation Medicine, The University of Cincinnati College of Medicine, Cincinnati, Ohio
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
14. November 2013 (online)

    Lizenzen und Reprints

Abstract

Dementia with Lewy bodies (DLB) is a synucleinopathy that is clinically distinct from Alzheimer's disease, associated with cognitive decline, fluctuations in alertness and cognition, visual hallucinations, and parkinsonism. Other clinical symptoms that can occur with DLB include dysautonomia and sleep disorders such as rapid-eye-movement sleep behavior disorder (RBD). The pathological criteria of DLB are associated with the location of Lewy body pathology and the extent of Alzheimer's pathology seen. Treatment is symptomatic. The genetic basis of DLB is being explored, and future studies will investigate ways to identify those most at risk for DLB prior to the onset of cognitive symptoms.

Keywords

Lewy bodies - synucleinopathy - REM sleep behavior disorder - dysautonomia - parkinsonism
 

  • References

  • 1 McKeith IG, Dickson DW, Lowe J , et al; Consortium on DLB. Diagnosis and management of dementia with Lewy bodies: third report of the DLB Consortium. Neurology 2005; 65 (12) 1863-1872
    CrossrefPubMedGoogle Scholar
  • 2 Vann Jones SA, O'Brien JT. The prevalence and incidence of dementia with Lewy bodies: a systematic review of population and clinical studies. Psychol Med 2013; 25: 1-11
    CrossrefPubMedGoogle Scholar
  • 3 Ricci M, Guidoni SV, Sepe-Monti M , et al. Clinical findings, functional abilities and caregiver distress in the early stage of dementia with Lewy bodies (DLB) and Alzheimer's disease (AD). Arch Gerontol Geriatr 2009; 49 (2) e101-e104
    CrossrefPubMedGoogle Scholar
  • 4 Boström F, Jönsson L, Minthon L, Londos E. Patients with Lewy body dementia use more resources than those with Alzheimer's disease. Int J Geriatr Psychiatry 2007; 22 (8) 713-719
    CrossrefPubMedGoogle Scholar
  • 5 Auning E, Rongve A, Fladby T , et al. Early and presenting symptoms of dementia with Lewy bodies. Dement Geriatr Cogn Disord 2011; 32 (3) 202-208
    CrossrefPubMedGoogle Scholar
  • 6 Hamilton JM, Landy KM, Salmon DP, Hansen LA, Masliah E, Galasko D. Early visuospatial deficits predict the occurrence of visual hallucinations in autopsy-confirmed dementia with Lewy bodies. Am J Geriatr Psychiatry 2012; 20 (9) 773-781
    CrossrefPubMedGoogle Scholar
  • 7 Park KW, Kim HS, Cheon SM, Cha JK, Kim SH, Kim JW. Dementia with Lewy bodies versus Alzheimer's disease and Parkinson's disease dementia: a comparison of cognitive profiles. J Clin Neurol 2011; 7 (1) 19-24
    CrossrefPubMedGoogle Scholar
  • 8 Lee DR, Taylor J-P, Thomas AJ. Assessment of cognitive fluctuation in dementia: a systematic review of the literature. Int J Geriatr Psychiatry 2012; 27 (10) 989-998
    CrossrefPubMedGoogle Scholar
  • 9 Ferman TJ, Smith GE, Boeve BF , et al. DLB fluctuations: specific features that reliably differentiate DLB from AD and normal aging. Neurology 2004; 62 (2) 181-187
    CrossrefPubMedGoogle Scholar
  • 10 Walker MP, Ayre GA, Cummings JL , et al. The Clinician Assessment of Fluctuation and the One Day Fluctuation Assessment scale. Two methods to assess fluctuating confusion in dementia. Br J Psychiatry 2000; 177: 252-256
    CrossrefPubMedGoogle Scholar
  • 11 McKeith IG, Rowan E, Askew K , et al. More severe functional impairment in dementia with Lewy bodies than Alzheimer disease is related to extrapyramidal motor dysfunction. Am J Geriatr Psychiatry 2006; 14 (7) 582-588
    CrossrefPubMedGoogle Scholar
  • 12 Ballard C, Aarsland D, Francis P, Corbett A. Neuropsychiatric symptoms in patients with dementias associated with cortical Lewy bodies: pathophysiology, clinical features, and pharmacological management. Drugs Aging 2013; 30 (8) 603-611
    CrossrefPubMedGoogle Scholar
  • 13 Ferman TJ, Arvanitakis Z, Fujishiro H , et al. Pathology and temporal onset of visual hallucinations, misperceptions and family misidentification distinguishes dementia with Lewy bodies from Alzheimer's disease. Parkinsonism Relat Disord 2013; 19 (2) 227-231
    CrossrefPubMedGoogle Scholar
  • 14 Sato Y, Berrios GE. Extracampine hallucinations. Lancet 2003; 361 (9367) 1479-1480
    CrossrefPubMedGoogle Scholar
  • 15 Bliwise DL, Mercaldo ND, Avidan AY, Boeve BF, Greer SA, Kukull WA. Sleep disturbance in dementia with Lewy bodies and Alzheimer's disease: a multicenter analysis. Dement Geriatr Cogn Disord 2011; 31 (3) 239-246
    CrossrefPubMedGoogle Scholar
  • 16 American Academy of Sleep Medicine. International Classification of Sleep Disorders, Second Edition: Diagnostic and Coding Manual. Westchester, IL: American of Academy of Sleep Medicine; 2005
    Google Scholar
  • 17 Horimoto Y, Matsumoto M, Akatsu H , et al. Autonomic dysfunctions in dementia with Lewy bodies. J Neurol 2003; 250 (5) 530-533
    CrossrefPubMedGoogle Scholar
  • 18 Idiaquez J, Roman GC. Autonomic dysfunction in neurodegenerative dementias. J Neurol Sci 2011; 305 (1-2) 22-27
    CrossrefPubMedGoogle Scholar
  • 19 Fujishiro H, Ferman TJ, Boeve BF , et al. Validation of the neuropathologic criteria of the third consortium for dementia with Lewy bodies for prospectively diagnosed cases. J Neuropathol Exp Neurol 2008; 67 (7) 649-656
    CrossrefPubMedGoogle Scholar
  • 20 Schneider JA, Arvanitakis Z, Yu L, Boyle PA, Leurgans SE, Bennett DA. Cognitive impairment, decline and fluctuations in older community-dwelling subjects with Lewy bodies. Brain 2012; 135 (Pt 10) 3005-3014
    CrossrefPubMedGoogle Scholar
  • 21 Knopman DS, DeKosky ST, Cummings JL , et al; Report of the Quality Standards Subcommittee of the American Academy of Neurology. Practice parameter: diagnosis of dementia (an evidence-based review). Neurology 2001; 56 (9) 1143-1153
    CrossrefPubMedGoogle Scholar
  • 22 Folstein MF, Folstein SE, McHugh PR. “Mini-mental state.” A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12 (3) 189-198
    CrossrefPubMedGoogle Scholar
  • 23 Nasreddine ZS, Phillips NA, Bédirian V , et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc 2005; 53 (4) 695-699
    CrossrefPubMedGoogle Scholar
  • 24 Kokmen E, Smith GE, Petersen RC, Tangalos E, Ivnik RC. The short test of mental status. Correlations with standardized psychometric testing. Arch Neurol 1991; 48 (7) 725-728
    CrossrefPubMedGoogle Scholar
  • 25 Kantarci K, Ferman TJ, Boeve BF , et al. Focal atrophy on MRI and neuropathologic classification of dementia with Lewy bodies. Neurology 2012; 79 (6) 553-560
    CrossrefPubMedGoogle Scholar
  • 26 Chow N, Aarsland D, Honarpisheh H , et al. Comparing hippocampal atrophy in Alzheimer's dementia and dementia with Lewy bodies. Dement Geriatr Cogn Disord 2012; 34 (1) 44-50
    CrossrefPubMedGoogle Scholar
  • 27 Pao WC, Boeve BF, Ferman TJ , et al. Polysomnographic findings in dementia with Lewy bodies. Neurologist 2013; 19 (1) 1-6
    CrossrefPubMedGoogle Scholar
  • 28 Kantarci K, Lowe VJ, Boeve BF , et al. Multimodality imaging characteristics of dementia with Lewy bodies. Neurobiol Aging 2012; 33 (9) 2091-2105
    CrossrefPubMedGoogle Scholar
  • 29 Taylor J-P, Firbank MJ, He J , et al. Visual cortex in dementia with Lewy bodies: magnetic resonance imaging study. Br J Psychiatry 2012; 200 (6) 491-498
    CrossrefPubMedGoogle Scholar
  • 30 O'Brien JT, McKeith IG, Walker Z , et al; DLB Study Group. Diagnostic accuracy of 123I-FP-CIT SPECT in possible dementia with Lewy bodies. Br J Psychiatry 2009; 194 (1) 34-39
    CrossrefPubMedGoogle Scholar
  • 31 Klunk WE, Engler H, Nordberg A , et al. Imaging brain amyloid in Alzheimer's disease with Pittsburgh compound-B. Ann Neurol 2004; 55 (3) 306-319
    CrossrefPubMedGoogle Scholar
  • 32 Kantarci K, Yang C, Schneider JA , et al. Antemortem amyloid imaging and β-amyloid pathology in a case with dementia with Lewy bodies. Neurobiol Aging 2012; 33 (5) 878-885
    CrossrefPubMedGoogle Scholar
  • 33 Tateno F, Sakakibara R, Kawai T, Kishi M, Murano T. Alpha-synuclein in the cerebrospinal fluid differentiates synucleinopathies (Parkinson disease, dementia with Lewy bodies, multiple system atrophy) from Alzheimer disease. Alzheimer Dis Assoc Disord 2012; 26 (3) 213-216
    CrossrefPubMedGoogle Scholar
  • 34 Meeus B, Theuns J, Van Broeckhoven C. The genetics of dementia with Lewy bodies: what are we missing?. Arch Neurol 2012; 69 (9) 1113-1118
    CrossrefPubMedGoogle Scholar
  • 35 Bonifati V. Recent advances in the genetics of dementia with Lewy bodies. Curr Neurol Neurosci Rep 2008; 8 (3) 187-189
    CrossrefPubMedGoogle Scholar
  • 36 Tsuang D, Leverenz JB, Lopez OL , et al. APOE ε4 increases risk for dementia in pure synucleinopathies. JAMA Neurol 2013; 70 (2) 223-228
    CrossrefPubMedGoogle Scholar
  • 37 Tsuang D, Leverenz JB, Lopez OL , et al. GBA mutations increase risk for Lewy body disease with and without Alzheimer disease pathology. Neurology 2012; 79 (19) 1944-1950
    CrossrefPubMedGoogle Scholar
  • 38 Creese B, Ballard C, Aarsland D, Londos E, Sharp S, Jones E. Determining the association of the 5HTTLPR polymorphism with delusions and hallucinations in Lewy body dementia. Am J Geriatr Psychiatry 2013; [Epub ahead of print]
    PubMedGoogle Scholar
  • 39 Mori E, Ikeda M, Kosaka K ; Donepezil-DLB Study Investigators Donepezil for dementia with Lewy bodies: a randomized, placebo-controlled trial. Ann Neurol 2012; 72 (1) 41-52
    CrossrefPubMedGoogle Scholar
  • 40 Emre M, Tsolaki M, Bonuccelli U , et al; 11018 Study Investigators. Memantine for patients with Parkinson's disease dementia or dementia with Lewy bodies: a randomised, double-blind, placebo-controlled trial. Lancet Neurol 2010; 9 (10) 969-977
    CrossrefPubMedGoogle Scholar
  • 41 Rolinski M, Fox C, Maidment I, McShane R. Cholinesterase inhibitors for dementia with Lewy bodies, Parkinson's disease dementia and cognitive impairment in Parkinson's disease. Cochrane Database Syst Rev 2012; 3: CD006504
    PubMedGoogle Scholar
  • 42 Molloy S, McKeith IG, O'Brien JT, Burn DJ. The role of levodopa in the management of dementia with Lewy bodies. J Neurol Neurosurg Psychiatry 2005; 76 (9) 1200-1203
    CrossrefPubMedGoogle Scholar
  • 43 Wang PS, Schneeweiss S, Avorn J , et al. Risk of death in elderly users of conventional vs. atypical antipsychotic medications. N Engl J Med 2005; 353 (22) 2335-2341
    CrossrefPubMedGoogle Scholar
  • 44 Schutte-Rodin S, Broch L, Buysse D, Dorsey C, Sateia M. Clinical guideline for the evaluation and management of chronic insomnia in adults. J Clin Sleep Med 2008; 4 (5) 487-504
    PubMedGoogle Scholar
  • 45 Aurora RN, Zak RS, Maganti RK , et al; Standards of Practice Committee; American Academy of Sleep Medicine. Best practice guide for the treatment of REM sleep behavior disorder (RBD). J Clin Sleep Med 2010; 6 (1) 85-95
    PubMedGoogle Scholar
  • 46 Thurman DJ, Stevens JA, Rao JK ; Quality Standards Subcommittee of the American Academy of Neurology. Practice parameter: Assessing patients in a neurology practice for risk of falls (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2008; 70 (6) 473-479
    CrossrefPubMedGoogle Scholar
  • 47 Iverson DJ, Gronseth GS, Reger MA, Classen S, Dubinsky RM, Rizzo M ; Quality Standards Subcommittee of the American Academy of Neurology. Practice parameter update: evaluation and management of driving risk in dementia: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2010; 74 (16) 1316-1324
    CrossrefPubMedGoogle Scholar
  • 48 Jack Jr CR, Albert MS, Knopman DS , et al. Introduction to the recommendations from the National Institute on Aging-Alzheimer's Association Workgroups on Diagnostic Guidelines for Alzheimer's Disease. Alzheimers Dement 2011; 7 (3) 257-262
    CrossrefPubMedGoogle Scholar
  • 49 Boeve BF, Silber MH, Ferman TJ , et al. Clinicopathologic correlations in 172 cases of rapid eye movement sleep behavior disorder with or without a coexisting neurologic disorder. Sleep Med 2013; 14 (8) 754-762
    CrossrefPubMedGoogle Scholar
  • 50 Ferini-Strambi L. Does idiopathic REM sleep behavior disorder (iRBD) really exist? What are the potential markers of neurodegeneration in iRBD?. Sleep Med 2011; 12 (Suppl. 02) S43-S49
    PubMedGoogle Scholar
  • 51 McCarter SJ, St Louis EK, Boeve BF. REM sleep behavior disorder and REM sleep without atonia as an early manifestation of degenerative neurological disease. Curr Neurol Neurosci Rep 2012; 12 (2) 182-192
    CrossrefPubMedGoogle Scholar
  • 52 Manni R, Sinforiani E, Pacchetti C, Zucchella C, Cremascoli R, Terzaghi M. Cognitive dysfunction and REM sleep behavior disorder: Key findings in the literature and preliminary longitudinal findings. Int J Psychophysiol 2013; 89 (2) 213-217
    CrossrefPubMedGoogle Scholar
  • 53 Molano JR, Boeve BF, Ferman T , et al. Mild cognitive impairment associated with limbic and neocortical Lewy body disease: a clinicopathological study. Brain 2010; 133 (Pt 2) 540-556
    CrossrefPubMedGoogle Scholar
  • 54 Boot BP, Boeve BF, Roberts RO , et al. Probable rapid eye movement sleep behavior disorder increases risk for mild cognitive impairment and Parkinson disease: a population-based study. Ann Neurol 2012; 71 (1) 49-56
    CrossrefPubMedGoogle Scholar
  • 55 Postuma RB, Gagnon JF, Pelletier A, Montplaisir J. Prodromal autonomic symptoms and signs in Parkinson's disease and dementia with Lewy bodies. Mov Disord 2013; 28 (5) 597-604
    CrossrefPubMedGoogle Scholar
  • 56 Miyamoto M, Miyamoto T. Neuroimaging of rapid eye movement sleep behavior disorder: transcranial ultrasound, single-photon emission computed tomography, and positron emission tomography scan data. Sleep Med 2013; 14 (8) 739-743
    CrossrefPubMedGoogle Scholar
  • 57 Jennum P, Mayer G, Ju YE, Postuma R. Morbidities in rapid eye movement sleep behavior disorder. Sleep Med 2013; 14 (8) 782-787
    CrossrefPubMedGoogle Scholar
  • 58 Ju YE, Larson-Prior L, Duntley S. Changing demographics in REM sleep behavior disorder: possible effect of autoimmunity and antidepressants. Sleep Med 2011; 12 (3) 278-283
    CrossrefPubMedGoogle Scholar