Abstract
ObjectiveTo investigate the clinical features of dementia with Lewy bodies (DLB) in a Chinese population.MethodsComputer-based online searches through China Biology Medicine disc and China National Knowledge Infrastructure were performed to collect case reports of DLB published between 1980 and 2012. Clinical characteristics were analyzed.ResultsA total of 18 studies comprising 35 patients (26 males and 9 females) were included. The mean age at onset was 67.2 ± 9.8 years. Onset was characterized by memory impairment and accounted for 58.8% of all cases, followed by parkinsonism (11.8%), visual hallucinations (8.8%), and compulsive personality disorder (2.9%). The other patients (17.6%) presented two of the three core features of DLB at onset. With disease progression, parkinsonism was reported in 100% of cases, followed by visual hallucinations (97.1%), psychiatric symptoms (85.7%), severe neuroleptic sensitivity (81.8%), fluctuating cognition (68.6%), repeated falls (40.0%), sleep disorders (22.9%), and transient loss of consciousness (17.1%). 26 patients who were subjected to Mini-Mental State Examination scored ≤ 24. 10 patients presented relative preservation of hippocampus and medial temporal lobe structures on CT/MRI scan. Occipital hypometabolism occurred in 2 of 3 patients who underwent SPECT/PET perfusion scan. 12 patients showed an increasing of slow frequency activity on EEG, prominently in frontal and temporal lobes.ConclusionsDLB often strikes elderly individuals. Its clinical core features are dementia, fluctuating cognition, recurrent visual hallucinations and spontaneous features of parkinsonism. Neuropsychological, neuroimaging and EEG examinations may improve the diagnostic accuracy and discriminate DLB from other dementias.
Highlights
Dementia with lewy bodies (DLB) is the second most prevalent cause of degenerative dementia after Alzheimer disease (AD) in older people, accounting for 10% of all cases [1]
A total of 81 articles related to DLB were collected. 63 articles were excluded for duplication, non-clinical research or lacking of essential clinical materials
Therapy Of the 24 patients who were treated with L-dopar, 12 patients had a mild to moderate improvement in extrapyramidal symptoms, 11 patients had no significant improvement, 1 patient was subject to exacerbation. 2 patients who were treated with selegiline had a mild improvement
Summary
A total of 81 articles related to DLB were collected. 63 articles were excluded for duplication, non-clinical research or lacking of essential clinical materials. A total of 18 studies comprising 35 DLB patients were included (26 males and 9 females), with a mean onset age of 67.2 ± 9.8 years (range 40–81 years). 35 patients (100%) manifested the symptoms of parkinsonism, including rigidity, bradykinesia, postural instability and gait difficulty (8 patients presented rest tremor). 30 patients (85.7%) had neuropsychiatric symptoms, including irritability, apathy, auditory hallucination, illusion, anxiety and depression. Therapy Of the 24 patients who were treated with L-dopar, 12 patients had a mild to moderate improvement in extrapyramidal symptoms, 11 patients had no significant improvement, 1 patient was subject to exacerbation. 2 patients who were treated with selegiline had a mild improvement. 8 patients who were treated with donepezil (5-10 mg/d) had a mild to moderate improvement in dementia and neuropsychiatric symptoms Of the 12 patients who had used the neuroleptic agents, 11 patients showed severe neuroleptic sensitivity (6 patients used perphenazine, 2 patients used risperidone, 1 patient used clozapine, 1 patient used olanzapine, 1 patient used haloperidol), and 1 patient had a mild improvement after using a small dose of quetiapine. 8 patients who were treated with donepezil (5-10 mg/d) had a mild to moderate improvement in dementia and neuropsychiatric symptoms
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