Diagnosis and management of dementia with Lewy bodies
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Résumé
The Dementia with Lewy Bodies (DLB) Consortium has refined its recommendations about the clinical and pathologic diagnosis of DLB, updating the previous report, which has been in widespread use for the last decade. The revised DLB consensus criteria now distinguish clearly between clinical features and diagnostic biomarkers, and give guidance about optimal methods to establish and interpret these. Substantial new information has been incorporated about previously reported aspects of DLB, with increased diagnostic weighting given to REM sleep behavior disorder and 123 iodine-metaiodobenzylguanidine (MIBG) myocardial scintigraphy. The diagnostic role of other neuroimaging, electrophysiologic, and laboratory investigations is also described. Minor modifications to pathologic methods and criteria are recommended to take account of Alzheimer disease neuropathologic change, to add previously omitted Lewyrelated pathology categories, and to include assessments for substantia nigra neuronal loss. Recommendations about clinical management are largely based upon expert opinion since randomized controlled trials in DLB are few. Substantial progress has been made since the previous report in the detection and recognition of DLB as a common and important clinical disorder. During that period it has been incorporated into DSM-5, as major neurocognitive disorder with Lewy bodies. There remains a pressing need to understand the underlying neurobiology and pathophysiology of DLB, to develop and deliver clinical trials with both symptomatic and disease-modifying agents, and to help patients and carers worldwide to inform themselves about the disease, its prognosis, best available treatments, ongoing research, and how to get adequate support. Neurology 2017;89:88-100 GLOSSARY AD 5 Alzheimer disease; CHEI 5 cholinesterase inhibitor; DAT 5 dopamine transporter; DLB 5 dementia with Lewy bodies; DSM-5 5 Diagnostic and Statistical Manual of Mental Disorders, 5th edition; LB 5 Lewy body; MCI 5 mild cognitive impairment; MIBG 5 metaiodobenzylguanidine; MMSE 5 Mini-Mental State Examination; MTL 5 medial temporal lobe; PD 5 Parkinson disease; PSG 5 polysomnography; RBD 5 REM sleep behavior disorder.
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La notice
- Revue
- Neurology
- Thématique
- Parkinson's Disease Mechanisms and Treatments
- Domaine
- Medicine
- Établissements canadiens
- —
- Organismes subventionnaires
- National Institute of Neurological Disorders and StrokeNational Institute for Dementia ResearchNational Institute on AgingNIHR Newcastle Biomedical Research CentreProgramme Grants for Applied ResearchNational Health and Medical Research CouncilMedical Research CouncilCanadian Institutes of Health ResearchQatar Biomedical Research Institute, Hamad Bin Khalifa UniversityHouston Methodist Research InstituteAvid RadiopharmaceuticalsPerelman School of Medicine, University of PennsylvaniaGenentechUniversité de StrasbourgH. Lundbeck A/SU.S. Department of Health and Human ServicesTauRx PharmaceuticalsNewcastle upon Tyne Hospitals NHS Foundation TrustEisaiMinistero della SaluteUniversity College LondonCentre National de la Recherche ScientifiqueKing's College LondonUniversity of ExeterNational Institute for Health and Care ResearchUniversity of OxfordACADIA PharmaceuticalsFondation Brain CanadaPfizerUniversity of WashingtonTeva Pharmaceutical IndustriesBristol-Myers SquibbCleveland ClinicCurePSPMassachusetts General HospitalLittle Family FoundationU.S. Department of Veterans AffairsUniversity of PennsylvaniaAlzheimer's Drug Discovery FoundationNational Institutes of HealthKanazawa UniversityDemensförbundetFlorida Department of HealthThomas Jefferson UniversityCHDI FoundationInternational Parkinson and Movement Disorder SocietyBiogenRush UniversityUniversity of TorontoUniversity of North Carolina at Chapel HillVan Andel Research InstituteUniversidad del AtlánticoUniversity of California, San DiegoHouston Methodist HospitalMinistero dello Sviluppo EconomicoNewcastle UniversityHeart and Stroke Foundation of CanadaSanofiWeston Brain InstituteCalifornia Institute for Regenerative MedicineFlorida Atlantic UniversityEli Lilly and Company
- Mots-clés
- Dementia with Lewy bodiesNeurocognitiveREM sleep behavior disorderMedicineClinical trialNeuroimagingDementiaDiseaseLewy bodyPsychiatryIntensive care medicinePsychologyParkinson's diseaseNeurosciencePathologyCognition
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