Dementia with Lewy bodies.

Abstract

An increasing variety of neurological syndromes and brain disorders have been associated with Lewy body pathology in various parts of the nervous system’. The major dementia syndromes in which Lewy bodies are frequently identified are Dementia with Lewy bodies (DLB), dementia arising in Parkinson’s disease, and Alzheimer’s disease. Within each of these clinico-pathological umbrellas many patients can be allocated to the core syndromes based on a combination of clinical features and the pathological changes demonstrable at autopsy. However, there is a substantial, and currently unquantified, overlap between them such that some authors have proposed a continuum of Lewy body and Alzheimer-type pathologies2. The paradigms of Parkinson’s disease and Alzheimer’s disease have been absorbed into clinical practice, pathological interpretation at autopsy, and models of pathogenesis, to such an extent that DLB has been difficult to assimilate. DLB is currently defined in terms of a clinical syndrome and prospective pathological studies suggest that this syndrome predicts the presence of Lewy body pathology at least as well as a diagnosis of AD can predict the pathology of that disorder3. Similar considerations apply to Parkinson’s disease so that for each of the three syndromes the currently accepted clinical criteria for their diagnosis is likely to be verified at autopsy in at least 4 out of 5 cases. The clinical features of DLB are defined in the published consensus criteria from an International Workshop held in 19954. Many studies published subsequently have turned the concept of DLBKeywordsLewy BodyDementia With Lewy BodyLewy Body DiseaseLewy Body DementiaDementia With Lewy Body PatientThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.