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Manifestaciones clínicas

Giulia Zazzaro1, Desirée Conti1, Massimiliano Panigutti1

  • 1Fondazione Santa Lucia IRCCS, Rome, Italy.

Alzheimer's & dementia : the journal of the Alzheimer's Association
|December 25, 2025
PubMed
Resumen
Este resumen es generado por máquina.

Los pacientes con demencia prodrómica con cuerpos de Lewy (pro-DLB) presentan cambios cognitivos y cerebrales distintos en comparación con la enfermedad de Alzheimer. Las pruebas neuropsicológicas deben centrarse en la atención, las habilidades visoespaciales y las funciones ejecutivas para un diagnóstico preciso de pro-DLB.

Palabras clave:
demencia prodrómica con cuerpos de Lewyenfermedad de Alzheimerdeterioro cognitivo levemarcadores neuropsicológicosresonancia magnéticaneuroimagenatenciónfunciones ejecutivashabilidades visoespaciales

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Área de la Ciencia:

  • Neurología
  • Neurociencia
  • Ciencia Cognitiva

Sus antecedentes:

  • La etapa prodrómica de la demencia con cuerpos de Lewy (pro-DLB) se define recientemente, pero su perfil neuropsicológico y de neuroimagen en diferentes inicios clínicos sigue sin investigarse.
  • Comprender estos perfiles es crucial para el diagnóstico temprano y la diferenciación de pro-DLB de otras condiciones neurodegenerativas como la enfermedad de Alzheimer (AD).

Objetivo del estudio:

  • Aclarar los marcadores neuropsicológicos y de neuroimagen específicos que diferencian la pro-DLB del deterioro cognitivo leve debido a AD (MCI-AD).
  • Investigar cómo el inicio clínico (MCI-DLB, inicio psiquiátrico, inicio de delirium) influye en estos marcadores en pro-DLB.

Principales métodos:

  • Una cohorte de 26 pacientes con pro-DLB (incluidos MCI-DLB, inicio psiquiátrico y inicio de delirium) y 15 pacientes con MCI-AD se sometieron a evaluaciones neuropsicológicas integrales.
  • Se utilizaron resonancia magnética estructural y morfometría basada en vóxeles (VBM) para comparar las diferencias de volumen de materia gris entre pacientes con pro-DLB, MCI-AD y controles sanos.

Principales resultados:

  • Los pacientes con pro-DLB demostraron déficits significativos en alerta, memoria de trabajo, procesamiento visoespacial, razonamiento abstracto y planificación en comparación con MCI-AD.
  • Los síntomas neuropsiquiátricos como ansiedad y alucinaciones fueron más prevalentes en pro-DLB.
  • La neuroimagen reveló atrofia aumentada en las regiones occipital, parietal y frontal, incluido el núcleo accumbens, con preservación relativa del lóbulo temporal medial en pro-DLB en comparación con MCI-AD.

Conclusiones:

  • El perfil neuropsicológico de pro-DLB se caracteriza por déficits en habilidades visoespaciales, funciones ejecutivas y atención, consistente con la enfermedad en pleno desarrollo.
  • Los hallazgos de neuroimagen se correlacionan con los síntomas cognitivos y neuropsiquiátricos observados, lo que respalda patrones distintos de atrofia regional en los fenotipos de pro-DLB.
  • Se recomiendan evaluaciones neuropsicológicas dirigidas a estos dominios para una identificación precisa de pro-DLB.