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Demencias por cuerpos de Lewy

Zuzana Walker¹, Katherine L Possin², Bradley F Boeve³

¹Division of Psychiatry, University College London, London, UK; North Essex Partnership University NHS Foundation Trust, Epping, UK.

Lancet (London, England)

|November 24, 2015

Resumen

Las demencias con cuerpos de Lewy, la segunda demencia más común en adultos mayores, a menudo son diagnosticadas erróneamente. Los avances recientes se centran en mejorar el diagnóstico y desarrollar tratamientos dirigidos a la patología subyacente para un mejor manejo del paciente.

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Área de la Ciencia:

Neurología
La neurociencia
Enfermedad de los ancianos

Sus antecedentes:

La demencia es una preocupación de salud global significativa, y la enfermedad de Alzheimer recibe un enfoque de investigación sustancial.
Las demencias con cuerpos de Lewy (LBD), que abarcan la demencia con cuerpos de Lewy y la demencia por enfermedad de Parkinson, son la segunda demencia degenerativa más frecuente en personas mayores de 65 años.
A pesar de su prevalencia, la LBD a menudo sufre de subdiagnóstico y manejo subóptimo del paciente.

Objetivo del estudio:

Revisar los avances recientes en el diagnóstico y la comprensión de las demencias por cuerpos de Lewy.
Resaltar los desafíos y las direcciones futuras para el desarrollo de tratamientos efectivos para la LBD.
Hacer hincapié en la necesidad de mejorar la precisión del diagnóstico y las terapias dirigidas.

Principales métodos:

Revisión de la literatura científica pertinente de los últimos 10 años.
Análisis del progreso en el perfeccionamiento de los criterios de diagnóstico de la LBD.
Evaluación del papel de las imágenes y los biomarcadores en el diagnóstico de la LBD.

Principales resultados:

Se han realizado esfuerzos significativos para mejorar la precisión del diagnóstico de la LBD.
Se reconoce la fisiopatología compartida entre la demencia con cuerpos de Lewy y la demencia de la enfermedad de Parkinson.
Se ha avanzado en la identificación de marcadores de diagnóstico y la comprensión de los mecanismos de la enfermedad.

Conclusiones:

El mejoramiento del diagnóstico y el desarrollo de biomarcadores son cruciales para la LBD.
Los tratamientos futuros deben dirigirse a los mecanismos patológicos de la LBD, idealmente pre-sintomáticos.
La clarificación de la patogénesis es esencial para el desarrollo de terapias modificadoras de la enfermedad para la LBD.