Autonomic dysfunction in dementia with Lewy bodies: Focusing on cardiovascular and respiratory dysfunction

Area of Science:

• Neurology
• Autonomic Neuroscience

Background:

• Dementia with Lewy bodies (DLB) is the second most common dementia, characterized by Lewy bodies in the cerebrum.
• Autonomic symptoms are prevalent in early DLB stages and are diagnostic criteria.
• Autonomic dysfunction significantly impacts daily living and quality of life in DLB patients.

Purpose of the Study:

• To review cardiovascular and respiratory dysfunction in DLB.
• To discuss assessment methods for autonomic function in DLB.
• To highlight the role of autonomic dysfunction in DLB differential diagnosis.

Main Methods:

• Review of existing literature on cardiovascular and respiratory assessments in DLB.
• Focus on diagnostic criteria and biomarkers for DLB.
• Analysis of studies evaluating autonomic function, including metaiodobenzylguanidine scintigraphy.

Main Results:

• DLB patients exhibit cardiovascular issues like orthostatic hypotension and abnormal heart rate variability.
• Metaiodobenzylguanidine myocardial scintigraphy shows decreased uptake, a key DLB biomarker.
• Respiratory abnormalities include reduced ventilatory response, abnormal rhythms, and sleep-disordered breathing.

Conclusions:

• Autonomic dysfunction is a key feature of DLB, present from early stages.
• Assessing autonomic function aids in differentiating DLB from Alzheimer's disease.
• Further research on the respiratory system's role in DLB is warranted.