Diagnosis and management of dementia with Lewy bodies

By Ian G. McKeith, Brad Boeve, Dennis W. Dickson, G. Halliday, John-Paul Taylor, Daniel Weintraub, Dag Aarsland, J. Galvin, J. Attems, C. Ballard and 53 more. Neurology, 2017

2,290 citations recorded by the source corpus.

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.

Subfields: Neurology, Physiology, Psychiatry and Mental health

View Paper: https://www.semanticscholar.org/paper/bf09b8b7b436f0623374afe18d037751599ad186

How researchers see this paper

The researchers whose trusted networks rank it highest, strongest advocate first. Every researcher gets a different order.

In Neurology

In Physiology

In Psychiatry and Mental health

Citations in the corpus

Research criteria for the diagnosis of prodromal dementia with Lewy bodies (2020, methodology): “It is characterized by dementia together with varying combinations of the core clinical features of parkinsonism, REM sleep behavior disorder (RBD), fluctuating cognition/alertness, and visual hallucinations.(2) There is a variable progression of α-synuclein aggregationmany years before the full DLB”
Pathology of Neurodegenerative Diseases. (2017, methodology): “Furthermore, the 2005 diagnostic criteria for DLB take into account both Lewy-related and AD-type pathologies to predict the likelihood that the observed pathology would be associated with the DLB clinical syndrome (McKeith et al. 2005).”
Clinical Neurology and Epidemiology of the Major Neurodegenerative Diseases. (2018, methodology): “Diagnostic criteria for DLB were first devised in 1996 and revised in 2005 by the DLB Consortium (McKeith et al. 2005).”
Risk and predictors of dementia and parkinsonism in idiopathic REM sleep behaviour disorder: a multicentre study (2019, methodology): “For dementia conversions, all patients had polysomnogram-diagnosed RBD; therefore, they met 2017 criteria for probable dementia with Lewy bodies with a clinical core symptom plus biomarker loss of REM atonia (McKeith et al., 2017).”