Abstract
This chapter reviews neuropsychological aspects of dementia with Lewy bodies (DLB) emphasizing comparative features to Parkinson's disease (PD) and Alzheimer's disease (AD), and underlying pathological substrates. Over the last decade substantial progress has been made in defining and characterizing clinical syndromes lying at the intersection of dementia and Parkinsonism. Whereas DLB as initially cast had more in common with AD vis-á-vis the term Lewy body variant of AD, DLB is now more directly linked to PD and PDD by the common thread of alphasynuclein pathology. Recently revised diagnostic criteria for DLB detail specific signs and symptoms (visual hallucinations, RBD, etc.) although specific cognitive profiling is remarkably absent from the diagnostic criteria. Treatments that increase cholinergic transmission are developed based on the role of acetylcholine in learning and memory, but have proven to be useful in treating attentional and other noncognitive symptoms associated with DLB and PDD. These findings are consistent with recent evidence that both disorders have greater central cholinergic deficits than AD, and that attentional and executive cognitive disturbances have been directly linked to decreased cortical cholinergic activity with in vivo PET imaging.
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