New Diagnostic Criteria and Treatment for Dementia with Lewy Bodies
10.47825/jkgp.2020.24.2.60
- Author:
Bo Kyung SOHN
1
;
Dong Woo LEE
Author Information
1. Department of Psychiatry, Inje University Sanggye Paik Hospital, Seoul, Korea
- Publication Type:Review Article
- From:Journal of Korean Geriatric Psychiatry
2020;24(2):60-68
- CountryRepublic of Korea
- Language:English
-
Abstract:
Dementia with Lewy bodies (DLB) is the second most common cause of neurodegenerative dementia. The Dementia with Lewy Bodies Consortium has revised DLB consensus diagnostic criteria. We reviewed recent (fourth) clinical diagnosis criteria and treatment options. The revised DLB clinical criteria included clinical features and updated diagnostic biomarkers. Compared with third criteria, they removed suggestive features and reassigned rapid eye movement sleep behavior disorder (RBD) in core clini-cal features with fluctuating cognition, recurrent visual hallucination, and parkinsonism. They classified biomarkers into two groups, indicative and supportive biomarkers, according to diagnostic specificity and evidence quality. Indicative biomarkers in-cluded reduced dopamine transporter uptake in basal ganglia demonstrated by single-photon emission CT or positron emission tomography, low uptake 123 Iodine- metaiodobenzylguanidine myocardial scintigraphy, and RBD in polysomnography. In treatment of DLB, cholinesterase inhibitor can improve cognitive function and activities of daily living. Neuroleptics should use with caution due to sensitivity in DLB.
