The clinical characteristics of dementia with Lewy bodies and a consideration of prodromal diagnosis

摘要: Dementia with Lewy bodies (DLB) is the second most common type of degenerative dementia following Alzheimer’s disease (AD). DLB clinically and pathologically related to Parkinson's (PD) PD dementia, three disorders can be viewed as existing on a spectrum body disease. In recent years there has been concerted effort establish phenotypes AD in prodromal phase (before respective syndromes cognitive motor impairment are expressed). Evidence for presentation also emerging. This paper briefly reviews what known about clinical before discussing pathology how this relates potential biomarkers DLB. The presenting features broadly placed categories: (particularly nonamnestic impairments), behavioural/psychiatric phenomena (for example, hallucinations, rapid eye movement sleep behaviour disorder (RBD)) physical symptoms parkinsonism, decreased sense smell, autonomic dysfunction). Some noncognitive such constipation, RBD, hyposmia postural dizziness predate onset memory by several Pathological studies have found that earliest sites involvement olfactory bulb, dorsal nucleus vagal nerve, peripheral nervous system, including enteric brainstem. promising early markers include presence dysfunction or hyposmia, 123I-metaiodobenzylguanidine cardiac scintigraphy, measures substantia nigra skin biopsy α-synuclein nerves. absence disease-modifying therapies, diagnosis limited use clinic. That said, knowledge development could help clinicians identify cases where uncertain. Prodromal great importance research, identifying at an earlier stage may allow researchers investigate initial phases pathophysiology, develop treatments designed interrupt syndrome accurately patients likely benefit from these treatments.