| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
From the Institute for the Health of the Elderly, Newcastle General Hospital, Newcastle upon Tyne, UK.
Address correspondence and reprint requests to Dr. Ian McKeith, Professor of Old Age Psychiatry, Wolfson Research Centre, Institute for the Health of the Elderly, Newcastle General Hospital, Westgate Road, Newcastle upon Tyne NE4 6BE, UK.
OBJECTIVE: To determine the validity of a clinical diagnosis of probable or possible dementia with Lewy bodies (DLB) made using International Consensus criteria.
BACKGROUND: Validation studies based on retrospective chart reviews of autopsy-confirmed cases have suggested that diagnostic specificity for DLB is acceptable but case detection rates as low as 0.22 have been suggested.
METHODS: We evaluated the first 50 cases reaching neuropathologic autopsy in a cohort to which Consensus clinical diagnostic criteria for DLB, National Institute for Neurological and Communicative Disorders and Stroke–Alzheimer’s Disease and Related Disorders Association criteria for AD, and National Institute of Neurological Disorders and Stroke–Association Internationale pour la Recherche et l’Enseignement en Neurosciences criteria for vascular dementia (VaD) had been prospectively applied.
RESULTS: Twenty-six clinical diagnoses of DLB, 19 of AD, and 5 of VaD were made. At autopsy, 29 DLB cases, 15 AD, 5 VaD, and 1 progressive supranuclear palsy were identified. The sensitivity and specificity of a clinical diagnosis of probable DLB in this sample were 0.83 and 0.95. Of the five cases receiving a false-negative diagnosis of DLB, significant fluctuation was present in four but visual hallucinations and spontaneous motor features of parkinsonism were generally absent. Thirty-one percent of the DLB cases had additional vascular pathology and in two cases this contributed to a misdiagnosis of VaD. No correlations were found between the distribution of Lewy bodies and clinical features.
CONCLUSION: The Consensus criteria for DLB performed as well in this prospective study as those for AD and VaD, with a diagnostic sensitivity substantially higher than that reported by previous retrospective studies. DLB occurs in the absence of extrapyramidal features and in the presence of comorbid cerebrovascular disease. Fluctuation is an important diagnostic indicator, reliable measures of which need to be developed further.
Key words: Dementia—Lewy bodies—Clinical criteria—Sensitivity and specificity.
This article has been cited by other articles:
|
|
 |
|
  Z. Walker, E. Jaros, R. W H Walker, L. Lee, D. C Costa, G. Livingston, P. G Ince, R. Perry, I. McKeith, and C. L E Katona Dementia with Lewy bodies: a comparison of clinical diagnosis, FP-CIT single photon emission computed tomography imaging and autopsy J. Neurol. Neurosurg. Psychiatry, November 1, 2007; 78(11): 1176 - 1181. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Inui, H. Toyama, Y. Manabe, T. Sato, M. Sarai, K. Kosaka, N. Iwata, and K. Katada Evaluation of Probable or Possible Dementia with Lewy Bodies Using 123I-IMP Brain Perfusion SPECT, 123I-MIBG, and 99mTc-MIBI Myocardial SPECT J. Nucl. Med., October 1, 2007; 48(10): 1641 - 1650. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Weisman, M. Cho, C. Taylor, A. Adame, L. J. Thal, and L. A. Hansen In dementia with Lewy bodies, Braak stage determines phenotype, not Lewy body distribution Neurology, July 24, 2007; 69(4): 356 - 359. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. L. Whitwell, C. R. Jack Jr, J. E. Parisi, D. S. Knopman, B. F. Boeve, R. C. Petersen, T. J. Ferman, D. W. Dickson, and K. A. Josephs Rates of cerebral atrophy differ in different degenerative pathologies Brain, April 1, 2007; 130(4): 1148 - 1158. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. F. Lippa, J. E. Duda, M. Grossman, H. I. Hurtig, D. Aarsland, B. F. Boeve, D. J. Brooks, D. W. Dickson, B. Dubois, M. Emre, et al. DLB and PDD boundary issues: Diagnosis, treatment, molecular pathology, and biomarkers Neurology, March 13, 2007; 68(11): 812 - 819. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Tsuang, K. Simpson, E. B. Larson, E. Peskind, W. Kukull, J. B. Bowen, W. McCormick, L. Teri, T. Montine, M. L. Thompson, et al. Predicting lewy body pathology in a community-based sample with clinical diagnosis of Alzheimer's disease. J Geriatr Psychiatry Neurol, December 1, 2006; 19(4): 195 - 201. [Abstract] [PDF]
|
|
|
|
 |
|
 B. Borroni, M. Grassi, C. Costanzi, S. Archetti, L. Caimi, and A. Padovani APOE Genotype and Cholesterol Levels in Lewy Body Dementia and Alzheimer Disease: Investigating Genotype-Phenotype Effect on Disease Risk Am J Geriatr Psychiatry, December 1, 2006; 14(12): 1022 - 1031. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Papapetropoulos, A. Lieberman, J. Gonzalez, C. Singer, D. Z. Laufer, and D. C. Mash Family history of dementia: dementia with lewy bodies and dementia in Parkinson's disease. J Neuropsychiatry Clin Neurosci, December 1, 2006; 18(1): 113 - 116. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C Geroldi, R Rossi, C Calvagna, C Testa, L Bresciani, G Binetti, O Zanetti, and G B Frisoni Medial temporal atrophy but not memory deficit predicts progression to dementia in patients with mild cognitive impairment J. Neurol. Neurosurg. Psychiatry, November 1, 2006; 77(11): 1219 - 1222. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. F. Lippa An Individualized Approach to Treatment for Alzheimer's Disease, Pick's Disease, and Other Dementias. American Journal of Alzheimer's Disease and Other Dementias, October 1, 2006; 21(5): 354 - 359. [Abstract] [PDF]
|
|
|
|
|
|
J M Bradshaw, M Saling, V Anderson, M Hopwood, and A Brodtmann Higher cortical deficits influence attentional processing in dementia with Lewy bodies, relative to patients with dementia of the Alzheimer's type and controls J. Neurol. Neurosurg. Psychiatry, October 1, 2006; 77(10): 1129 - 1135. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. T. O'Brien Vascular Cognitive Impairment Am J Geriatr Psychiatry, September 1, 2006; 14(9): 724 - 733. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. G. McKeith, E. Rowan, K. Askew, A. Naidu, L. Allan, N. Barnett, D. Lett, U. P. Mosimann, D. Burn, and J. T. O'Brien More Severe Functional Impairment in Dementia With Lewy Bodies Than Alzheimer Disease Is Related to Extrapyramidal Motor Dysfunction Am J Geriatr Psychiatry, July 1, 2006; 14(7): 582 - 588. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Yoshita, J. Taki, K. Yokoyama, M. Noguchi-Shinohara, Y. Matsumoto, K. Nakajima, and M. Yamada Value of 123I-MIBG radioactivity in the differential diagnosis of DLB from AD Neurology, June 27, 2006; 66(12): 1850 - 1854. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. B. Leverenz, M. A. Fishel, E. R. Peskind, T. J. Montine, D. Nochlin, E. Steinbart, M. A. Raskind, G. D. Schellenberg, T. D. Bird, and D. Tsuang Lewy Body Pathology in Familial Alzheimer Disease: Evidence for Disease- and Mutation-Specific Pathologic Phenotype. Arch Neurol, March 1, 2006; 63(3): 370 - 376. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Tiraboschi, D. P. Salmon, L. A. Hansen, R. C. Hofstetter, L. J. Thal, and J. Corey-Bloom What best differentiates Lewy body from Alzheimer's disease in early-stage dementia? Brain, March 1, 2006; 129(3): 729 - 735. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
U. P. Mosimann, E. N. Rowan, C. E. Partington, D. Collerton, E. Littlewood, J. T. O'Brien, D. J. Burn, and I. G. McKeith Characteristics of Visual Hallucinations in Parkinson Disease Dementia and Dementia With Lewy Bodies Am J Geriatr Psychiatry, February 1, 2006; 14(2): 153 - 160. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. G. McKeith, D. W. Dickson, J. Lowe, M. Emre, J. T. O'Brien, H. Feldman, J. Cummings, J. E. Duda, C. Lippa, E. K. Perry, et al. Diagnosis and management of dementia with Lewy bodies: Third report of the DLB consortium Neurology, December 27, 2005; 65(12): 1863 - 1872. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J M Olichney, C Murphy, C R Hofstetter, K Foster, L A Hansen, L J Thal, and R Katzman Anosmia is very common in the Lewy body variant of Alzheimer's disease J. Neurol. Neurosurg. Psychiatry, October 1, 2005; 76(10): 1342 - 1347. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. A. Koeppe, S. Gilman, A. Joshi, S. Liu, R. Little, L. Junck, M. Heumann, K. A. Frey, and R. L. Albin 11C-DTBZ and 18F-FDG PET Measures in Differentiating Dementias J. Nucl. Med., June 1, 2005; 46(6): 936 - 944. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
U. P. Mosimann, R. M. Muri, D. J. Burn, J. Felblinger, J. T. O'Brien, and I. G. McKeith Saccadic eye movement changes in Parkinson's disease dementia and dementia with Lewy bodies Brain, June 1, 2005; 128(6): 1267 - 1276. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. W.C. Tam, E. J. Burton, I. G. McKeith, D. J. Burn, and J. T. O'Brien Temporal lobe atrophy on MRI in Parkinson disease with dementia: A comparison with Alzheimer disease and dementia with Lewy bodies Neurology, March 8, 2005; 64(5): 861 - 865. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Marsh, J. R. Williams, M. Rocco, S. Grill, C. Munro, and T. M. Dawson Psychiatric comorbidities in patients with Parkinson disease and psychosis Neurology, July 27, 2004; 63(2): 293 - 300. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R A Kenny, F E Shaw, J T O'Brien, P H Scheltens, R Kalaria, and C Ballard Carotid sinus syndrome is common in dementia with Lewy bodies and correlates with deep white matter lesions J. Neurol. Neurosurg. Psychiatry, July 1, 2004; 75(7): 966 - 971. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. T. O'Brien, S. Colloby, J. Fenwick, E. D. Williams, M. Firbank, D. Burn, D. Aarsland, and I. G. McKeith Dopamine Transporter Loss Visualized With FP-CIT SPECT in the Differential Diagnosis of Dementia With Lewy Bodies Arch Neurol, June 1, 2004; 61(6): 919 - 925. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Z. Walker, D. C. Costa, R. W.H. Walker, L. Lee, G. Livingston, E. Jaros, R. Perry, I. McKeith, and C. L.E. Katona Striatal dopamine transporter in dementia with Lewy bodies and Parkinson disease: A comparison Neurology, May 11, 2004; 62(9): 1568 - 1572. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. J. Burton, I. G. McKeith, D. J. Burn, E. D. Williams, and J. T. O'Brien Cerebral atrophy in Parkinson's disease with and without dementia: a comparison with Alzheimer's disease, dementia with Lewy bodies and controls Brain, April 1, 2004; 127(4): 791 - 800. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J Bradshaw, M Saling, M Hopwood, V Anderson, and A Brodtmann Fluctuating cognition in dementia with Lewy bodies and Alzheimer's disease is qualitatively distinct J. Neurol. Neurosurg. Psychiatry, March 1, 2004; 75(3): 382 - 387. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. J. Ferman, G. E. Smith, B. F. Boeve, R. J. Ivnik, R. C. Petersen, D. Knopman, N. Graff-Radford, J. Parisi, and D. W. Dickson DLB fluctuations: Specific features that reliably differentiate DLB from AD and normal aging Neurology, January 27, 2004; 62(2): 181 - 187. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. F. Weiner, L. S. Hynan, B. Parikh, N. Zaki, C. L. White III, E. H. Bigio, A. M. Lipton, K. Martin-Cook, D. A. Svetlik, C. M. Cullum, et al. Can Alzheimer's Disease and Dementias with Lewy Bodies be Distinguished Clinically? J Geriatr Psychiatry Neurol, December 1, 2003; 16(4): 245 - 250. [Abstract] [PDF]
|
|
|
|
|
|
D. A. Cousins, E. J. Burton, D. Burn, A. Gholkar, I. G. McKeith, and J. T. O'Brien Atrophy of the putamen in dementia with Lewy bodies but not Alzheimer's disease: An MRI study Neurology, November 11, 2003; 61(9): 1191 - 1195. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Maddalena, A. Papassotiropoulos, B. Muller-Tillmanns, H. H. Jung, T. Hegi, R. M. Nitsch, and C. Hock Biochemical Diagnosis of Alzheimer Disease by Measuring the Cerebrospinal Fluid Ratio of Phosphorylated tau Protein to {beta}-Amyloid Peptide42 Arch Neurol, September 1, 2003; 60(9): 1202 - 1206. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Gomez-Tortosa, I. Gonzalo, S. Fanjul, M. J. Sainz, S. Cantarero, C. Cemillan, J. G. Yebenes, and T. del Ser Cerebrospinal Fluid Markers in Dementia With Lewy Bodies Compared With Alzheimer Disease Arch Neurol, September 1, 2003; 60(9): 1218 - 1222. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R A Barker and T Foltynie How common is dementia with Lewy bodies? J. Neurol. Neurosurg. Psychiatry, June 1, 2003; 74(6): 697 - 698. [Full Text] [PDF]
|
|
|
|
|
|
T Rahkonen, U Eloniemi-Sulkava, S Rissanen, A Vatanen, P Viramo, and R Sulkava Dementia with Lewy bodies according to the consensus criteria in a general population aged 75 years or older J. Neurol. Neurosurg. Psychiatry, June 1, 2003; 74(6): 720 - 724. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. J. Sahlas Dementia With Lewy Bodies and the Neurobehavioral Decline of Mervyn Peake Arch Neurol, June 1, 2003; 60(6): 889 - 892. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. F. Lippa and I. McKeith Dementia with Lewy bodies: Improving diagnostic criteria Neurology, May 27, 2003; 60(10): 1571 - 1573. [Full Text] [PDF]
|
|
|
|
|
|
A. R. Merdes, L. A. Hansen, D. V. Jeste, D. Galasko, C. R. Hofstetter, G. J. Ho, L. J. Thal, and J. Corey-Bloom Influence of Alzheimer pathology on clinical diagnostic accuracy in dementia with Lewy bodies Neurology, May 27, 2003; 60(10): 1586 - 1590. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. A. Jellinger, K. Seppi, and G. K. Wenning Accuracy of Diagnosis in Dementia With Lewy Bodies Arch Neurol, March 1, 2003; 60(3): 452 - 452. [Full Text] [PDF]
|
|
|
|
|
|
C.G. Ballard, D. Aarsland, I. McKeith, J. O'Brien, A. Gray, F. Cormack, D. Burn, T. Cassidy, R. Starfeldt, J.-P. Larsen, et al. Fluctuations in attention: PD dementia vs DLB with parkinsonism Neurology, December 10, 2002; 59(11): 1714 - 1720. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J Lindeboom, B Schmand, L Tulner, G Walstra, and C Jonker Visual association test to detect early dementia of the Alzheimer type J. Neurol. Neurosurg. Psychiatry, August 1, 2002; 73(2): 126 - 133. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Z Walker, D C Costa, R W H Walker, K Shaw, S Gacinovic, T Stevens, G Livingston, P Ince, I G McKeith, and C L E Katona Differentiation of dementia with Lewy bodies from Alzheimer's disease using a dopaminergic presynaptic ligand J. Neurol. Neurosurg. Psychiatry, August 1, 2002; 73(2): 134 - 140. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C Ballard, J O'Brien, and M Tovee Qualitative performance characteristics differentiate dementia with Lewy bodies and Alzheimer's disease J. Neurol. Neurosurg. Psychiatry, May 1, 2002; 72(5): 565 - 566. [Full Text] [PDF]
|
|
|
|
 |
|
 T. STEVENS, G. LIVINGSTON, G. KITCHEN, M. MANELA, Z. WALKER, and C. KATONA Islington study of dementia subtypes in the community The British Journal of Psychiatry, March 1, 2002; 180(3): 270 - 276. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. J. Robinson Probable Lewy Body Dementia Presenting as "Delirium" Psychosomatics, February 1, 2002; 43(1): 84 - 86. [Full Text]
|
|
|
|
|
|
A. J. Harding, G. A. Broe, and G. M. Halliday Visual hallucinations in Lewy body disease relate to Lewy bodies in the temporal lobe Brain, February 1, 2002; 125(2): 391 - 403. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M A Beno tez delRosario, M Feria, and F I M. Alvarez Hallucinations in an elderly cancer patient: opioid neurotoxicity or dementia with Lewy bodies? Palliative Medicine, January 1, 2002; 16(1): 71 - 72. [PDF]
|
|
|
|
|
|
F. Pompeu and J. H. Growdon Diagnosing Dementia With Lewy Bodies Arch Neurol, January 1, 2002; 59(1): 29 - 30. [Full Text] [PDF]
|
|
|
|
|
|
O. L. Lopez, J. T. Becker, D. I. Kaufer, R. L. Hamilton, R. A. Sweet, W. Klunk, and S. T. DeKosky Research Evaluation and Prospective Diagnosis of Dementia With Lewy Bodies Arch Neurol, January 1, 2002; 59(1): 43 - 46. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Apaydin, J. E. Ahlskog, J. E. Parisi, B. F. Boeve, and D. W. Dickson Parkinson Disease Neuropathology: Later-Developing Dementia and Loss of the Levodopa Response Arch Neurol, January 1, 2002; 59(1): 102 - 112. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Ballard, J. O'Brien, A. Gray, F. Cormack, G. Ayre, E. Rowan, P. Thompson, R. Bucks, I. McKeith, M. Walker, et al. Attention and Fluctuating Attention in Patients With Dementia With Lewy Bodies and Alzheimer Disease Arch Neurol, June 1, 2001; 58(6): 977 - 982. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. T. O'Brien, S. Paling, R. Barber, E. D. Williams, C. Ballard, I.G. McKeith, A. Gholkar, W. R. Crum, M. N. Rossor, and N. C. Fox Progressive brain atrophy on serial MRI in dementia with Lewy bodies, AD, and vascular dementia Neurology, May 22, 2001; 56(10): 1386 - 1388. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Lobotesis, J.D. Fenwick, A. Phipps, A. Ryman, A. Swann, C. Ballard, I.G. McKeith, and J.T. O'Brien Occipital hypoperfusion on SPECT in dementia with Lewy bodies but not AD Neurology, March 13, 2001; 56(5): 643 - 649. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
X. S. Hu, N. Okamura, H. Arai, M. Higuchi, T. Matsui, M. Tashiro, M. Shinkawa, M. Itoh, T. Ido, and H. Sasaki 18F-fluorodopa PET study of striatal dopamine uptake in the diagnosis of dementia with Lewy bodies Neurology, November 28, 2000; 55(10): 1575 - 1577. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. P. WALKER, C. G. BALLARD, G. A. AYRE, K. WESNES, J. L. CUMMINGS, I. G. McKEITH, and J. T. O'BRIEN The Clinician Assessment of Fluctuation and the One Day Fluctuation Assessment Scale: Two methods to assess fluctuating confusion in dementia The British Journal of Psychiatry, September 1, 2000; 177(3): 252 - 256. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
