Lewy Body Disorders - 14/12/17

Doi : 10.1016/j.ncl.2017.01.004

Douglas Galasko, MD
Department of Neurosciences, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0948, USA

Resumen

Dementia syndromes associated with Lewy bodies are subdivided into dementia with Lewy bodies (DLB), an underdiagnosed cause of dementia in the elderly, and Parkinson disease with dementia (PDD), cognitive impairment appearing in people diagnosed with Parkinson disease. Their neuropathologic substrates are the widespread distribution of aggregates of the protein α-synuclein in neurons in cortical brain regions, accompanied by variable Alzheimer pathology. Clinical features of DLB and PDD include distinctive changes in cognition, behavior, movement, sleep, and autonomic function. Diagnostic criteria for DLB and PDD incorporate these features. Current treatment options for DLB and PDD are symptomatic.

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Keywords : Lewy body, α-synuclein, Dementia, Diagnosis, Management

Esquema

Key points

Introduction

The what and where of dementia with Lewy bodies pathology

Epidemiology and risk factors

Diagnostic criteria and a clinical approach to Parkinson disease with dementia and dementia with Lewy bodies

Core clinical features

Suggestive features for dementia with Lewy bodies

Early stages of Parkinson disease with dementia and dementia with Lewy bodies

Biomarkers

Management and treatment of Parkinson disease with dementia and dementia with Lewy bodies

Future directions

Disclosures: Dr D. Galasko has received research funding from the National Institute on Aging, the California Institute for Regenerative Medicine, the Alzheimer’s Drug Discovery Foundation, and from the Michael J. Fox Foundation. He has received honoraria for serving as an advisor to vTv Therapeutics. He is a paid editor for the journal Alzheimer’s Research and Therapy. He has served on data safety boards for Eli Lilly and Company and Prothena Inc.