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Sökning: WFRF:(Perry EK)

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  • McKeith, IG, et al. (författare)
  • Diagnosis and management of dementia with Lewy bodies - Third report of the DLB consortium
  • 2005
  • Ingår i: Neurology. - : Ovid Technologies (Wolters Kluwer Health). - 1526-632X .- 0028-3878. ; 65:12, s. 1863-1872
  • Forskningsöversikt (refereegranskat)abstract
    • The dementia with Lewy bodies (DLB) Consortium has revised criteria for the clinical and pathologic diagnosis of DLB incorporating new information about the core clinical features and suggesting improved methods to assess them. REM sleep behavior disorder, severe neuroleptic sensitivity, and reduced striatal dopamine transporter activity on functional neuroimaging are given greater diagnostic weighting as features suggestive of a DLB diagnosis. The 1-year rule distinguishing between DLB and Parkinson disease with dementia may be difficult to apply in clinical settings and in such cases the term most appropriate to each individual patient should be used. Generic terms such as Lewy body (LB) disease are often helpful. The authors propose a new scheme for the pathologic assessment of LBs and Lewy neurites (LN) using alpha-synuclein immunohistochemistry and semiquantitative grading of lesion density, with the pattern of regional involvement being more important than total LB count. The new criteria take into account both Lewy-related and Alzheimer disease (AD)-type pathology to allocate a probability that these are associated with the clinical DLB syndrome. Finally, the authors suggest patient management guidelines including the need for accurate diagnosis, a target symptom approach, and use of appropriate outcome measures. There is limited evidence about specific interventions but available data suggest only a partial response of motor symptoms to levodopa: severe sensitivity to typical and atypical antipsychotics in similar to 50%, and improvements in attention, visual hallucinations, and sleep disorders with cholinesterase inhibitors.
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  • Sharp, SI, et al. (författare)
  • Cortical serotonin 1A receptor levels are associated with depression in patients with dementia with Lewy bodies and Parkinson's disease dementia
  • 2008
  • Ingår i: Dementia and geriatric cognitive disorders. - : S. Karger AG. - 1421-9824 .- 1420-8008. ; 26:4, s. 330-338
  • Tidskriftsartikel (refereegranskat)abstract
    • <i>Background:</i> Serotonin 1A receptors (5-HT<sub>1A</sub>) have not been studied in dementia with Lewy bodies (DLB) or Parkinson’s disease dementia (PDD) patients with depression. <i>Aim:</i> To examine 5-HT<sub>1A</sub> in DLB and PDD postmortem in relation to depression. <i>Methods:</i> [<sup>3</sup>H]8-hydroxy-2-dipropylaminotetralin binding to 5-HT<sub>1A</sub> was determined in temporal cortex (Brodmann areas, BA20 and BA36) from 10 DLB patients, 17 PDD patients and 9 controls. <i>Results:</i> 5-HT<sub>1A</sub> density was significantly higher in BA36 in combined DLB/PDD patients with depression, but was unaltered in BA20. <i>Conclusion: </i>Higher BA36 5-HT<sub>1A</sub> density in PDD and DLB patients than in control is dependent on whether the patient had experienced depression during life, not DLB/PDD diagnosis. A 5-HT<sub>1A</sub> antagonist adjuvant may improve treatment of depression in dementia.
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