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[Dementia: Where are the Lewy bodies?]
T Lebouvier1, J Delrieu, S Evain
1CMRR des Pays de Loire, hôpital Laënnec, CHU de Nantes, boulevard Professeur-Jacques-Monod, 44800 Saint-Herblain, France.
Revue Neurologique
|October 10, 2013
Summary
Dementia with Lewy bodies (DLB) is a common dementia, but often underdiagnosed due to diagnostic challenges. New clinical scales are needed to identify DLB, especially when co-occurring with Alzheimer's disease.
Area of Science:
- Neurology
- Neuroscience
- Pathology
Context:
- Dementia with Lewy bodies (DLB) is the second most common degenerative dementia in autopsy studies.
- Clinical diagnosis of DLB has low sensitivity and significant intercenter variability.
- DLB often co-occurs with Alzheimer's disease pathology, complicating clinical presentation.
Purpose:
- To highlight the challenges in diagnosing Dementia with Lewy bodies (DLB) in clinical practice.
- To identify reasons for the underdiagnosis of DLB, including diagnostic criteria and underestimation of non-motor symptoms.
- To emphasize the need for improved diagnostic tools for DLB, particularly in the context of co-pathology with Alzheimer's disease.
Summary:
- DLB diagnosis is hindered by imprecise criteria and underestimation of non-motor symptoms like REM-sleep behavior disorder.
- The frequent co-occurrence of Lewy bodies with Alzheimer's disease pathology often masks the DLB phenotype.
- Current diagnostic limitations necessitate the development of new clinical scales to address mixed pathologies.
Impact:
- Improved diagnostic accuracy for DLB will facilitate earlier intervention and better patient management.
- Development of new clinical scales can aid in distinguishing DLB from other dementias, especially Alzheimer's disease.
- Advances in DLB diagnosis are crucial for the development of targeted therapies for protein aggregate diseases.
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