Diagnosis and management of dementia with Lewy bodies
Диагностика и лечение деменции с тельцами Леви
2017-06-08
SCID: 54.1/ww6esfwj
Discuss with AI
DLB consensus criteriaDementia with Lewy bodiesLewy-related pathologyMIBG myocardial scintigraphyREM sleep behavior disorder
Figures from the paper
Abstract (AI)
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 123iodine-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 Lewy-related 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.
Key Findings
1
Clinical management recommendations rely largely on expert opinion because randomized controlled trials in DLB remain limited; further symptomatic and disease-modifying trials are needed.
2
REM sleep behavior disorder and 123I-MIBG myocardial scintigraphy receive increased diagnostic weighting in the revised DLB criteria.
3
The DLB Consortium updated consensus recommendations, clearly separating clinical features from diagnostic biomarkers and providing guidance for their interpretation.
4
The report describes roles for neuroimaging, electrophysiologic, and laboratory investigations in supporting DLB diagnosis.
5
Updated pathologic criteria incorporate Alzheimer disease neuropathologic change, additional Lewy-related pathology categories, and substantia nigra neuronal-loss assessment.
Research Object
Dementia with Lewy bodies (DLB) as a clinical and neuropathological disorder
Research Subject
Updated clinical and pathologic diagnostic criteria, biomarkers, investigative methods, and clinical management of DLB
Publication Details
Publication Date
2017-06-08
Journal
Publisher
ISSN
Open access PDF
Access Type
Author Information
Download PDF
Subscribe to digest