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2017 ; 89
(1
): 88-100
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Diagnosis and management of dementia with Lewy bodies: Fourth consensus report of
the DLB Consortium
#MMPMID28592453
McKeith IG
; Boeve BF
; Dickson DW
; Halliday G
; Taylor JP
; Weintraub D
; Aarsland D
; Galvin J
; Attems J
; Ballard CG
; Bayston A
; Beach TG
; Blanc F
; Bohnen N
; Bonanni L
; Bras J
; Brundin P
; Burn D
; Chen-Plotkin A
; Duda JE
; El-Agnaf O
; Feldman H
; Ferman TJ
; Ffytche D
; Fujishiro H
; Galasko D
; Goldman JG
; Gomperts SN
; Graff-Radford NR
; Honig LS
; Iranzo A
; Kantarci K
; Kaufer D
; Kukull W
; Lee VMY
; Leverenz JB
; Lewis S
; Lippa C
; Lunde A
; Masellis M
; Masliah E
; McLean P
; Mollenhauer B
; Montine TJ
; Moreno E
; Mori E
; Murray M
; O'Brien JT
; Orimo S
; Postuma RB
; Ramaswamy S
; Ross OA
; Salmon DP
; Singleton A
; Taylor A
; Thomas A
; Tiraboschi P
; Toledo JB
; Trojanowski JQ
; Tsuang D
; Walker Z
; Yamada M
; Kosaka K
Neurology
2017[Jul]; 89
(1
): 88-100
PMID28592453
show ga
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.