期刊
NEUROLOGY
卷 89, 期 1, 页码 88-100出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1212/WNL.0000000000004058
关键词
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资金
- Acadia Pharmaceuticals
- Alzheimer's Association
- Axovant Sciences
- Banner Health
- GE Healthcare
- Lewy Body Dementia Association
- Lewy Body Society
- Lundbeck
- National Institute on Aging
- National Institute on Neurologic Disease and Stroke
- NIH [R13 NS095618, P50-AG016574, RO1 NS082265, UO1 NS082134, P50 NS053488]
- UK NIHR Biomedical Research Centre
- Alzheimer's Research UK ARUK NE Network Centre
- Mangurian Foundation for Lewy Body Research
- National Health and Medical Research Council of Australia [1079679]
- Wolfson Foundation
- Royal Society
- Maudsley BRC for Mental Health
- BRU dementia
- Burroughs Wellcome Fund
- Alzheimer's Association/Michael J. Fox Foundation/Weston Biomarkers Across Neurodegenerative Disease initiative
- Pechenik Montague Award Fund
- NIHR Programme Grants for Applied Research [RP-PG-0610-10100 SHAPED]
- Michael J. Fox Foundation for Parkinson's Research (New York)
- National Parkinson's Foundation
- Mayo Clinic: A Morris K. Udall Parkinson's Disease Research Center of Excellence [NINDS P50 NS072187, NINDS R01 NS078086]
- Michael J. Fox Foundation for Parkinson's Research
- Mayo Clinic AD and Related Dementias Genetics Program
- Little Family Foundation
- Intramural Research Program of the National Institute on Aging, Department of Health and Human Services
- Morris K. Udall Parkinson's Disease Research Center of Excellence grant from NINDS [P50 NS053488]
- Italian Ministry of Health Ricerca Corrente
- Japan Foundation for Neuroscience and Mental Health
- [R21 NS 090243]
- Medical Research Council [G0900652, G0400074, G0502157, G1100540] Funding Source: researchfish
- National Institute for Health Research [NF-SI-0611-10048] Funding Source: researchfish
- MRC [G1100540, G0400074, G0502157, G0900652] Funding Source: UKRI
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 (123)iodine-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.
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