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Consensus guidelines for the clinical and pathologic diagnosis of dementia with Lewy bodies (DLB): Report of the consortium on DLB international workshop
Abstract
Recent neuropathologic autopsy studies found that 15 to 25% of elderly demented patients have Lewy bodies (LB) in their brainstem and cortex, and in hospital series this may constitute the most common pathologic subgroup after pure Alzheimer's disease (AD). The Consortium on Dementia with Lewy bodies met to establish consensus guidelines for the clinical diagnosis of dementia with Lewy bodies (DLB) and to establish a common framework for the assessment and characterization of pathologic lesions at autopsy. The importance of accurate antemortem diagnosis of DLB includes a characteristic and often rapidly progressive clinical syndrome, a need for particular caution with neuroleptic medication, and the possibility that DLB patients may be particularly responsive to cholinesterase inhibitors. We identified progressive disabling mental impairment progressing to dementia as the central feature of DLB. Attentional impairments and disproportionate problem solving and visuospatial difficulties are often early and prominent. Fluctuation in cognitive function, persistent well-formed visual hallucinations, and spontaneous motor features of parkinsonism are core features with diagnostic significance in discriminating DLB from AD and other dementias. Appropriate clinical methods for eliciting these key symptoms are described. Brainstem or cortical LB are the only features considered essential for a pathologic diagnosis of DLB, although Lewy-related neurites, Alzheimer pathology, and spongi…
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“The diagnosis was based on the initial clinical presentation with dementia followed by parkinsonism and the presence of cortical and subcortical α-synuclein/Ubiquitin-positive Lewy bodies (71).”
From LRRK2 mediates microglial neurotoxicity via NFATc2 in rodent models of synucleinopathies (2020) · cites this paper as [71]
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The new mutation, E46K, of α‐synuclein causes parkinson and Lewy body dementia
Zarranz, J. J., Alegre, J., Gómez‐Esteban, J. C., Lezcano, E., Ros, R., Ampuero, I., Vidal, L., Hoenicka, J., Rodriguez, O., Atarés, B., et al. (2004) · Annals of Neurology · doi:10.1002/ana.10795 · Cited by 2,737
Metadata
- Authors
- McKeith, I. G., Galasko, D., Kosaka, K., Perry, E. K., Dickson, D. W., Hansen, L. A., Salmon, D. P., Lowe, J., Mirra, S. S., Byrne, E. J., Lennox, G., Quinn, N. P., Edwardson, J. A., Ince, P. G., Bergeron, C., Burns, A., Miller, B. L., Lovestone, S., Collerton, D., Jansen, E. N. H., Ballard, C., de Vos, R. A. I., Wilcock, G. K., Jellinger, K. A., & Perry, R. H.
- Affiliations
- Newcastle upon Tyne Hospital (GB)
- ORCID
- Venue
- Neurology
- Published
- 1996-11
- Volume
- 47
- Issue
- 5
- Pages
- 1113-1124
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- OpenAlex
- W2123056519
- Cited by
- 3,960
- References
- 2
- Citations by year
- 2026: 28 · 2025: 38 · 2024: 46 · 2023: 50 · 2022: 51 · 2021: 72 · 2020: 72 · 2019: 105 · 2018: 106 · 2017: 130 · 2016: 129 · 2015: 119 · 2014: 135 · 2013: 148 · 2012: 160
- FWCI
- 72.06
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Neurology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Clinical Neurology › Parkinson's Disease Mechanisms and Treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Alzheimer's disease research and treatments
- Keywords
- dementia with Lewy bodies, diagnosis, neuropathology, Lewy bodies, cortical Lewy bodies, Alzheimer's disease, parkinsonism, visual hallucinations, cognitive fluctuations, cholinesterase inhibitors, antipsychotic drugs, frozen tissue storage
- MeSH terms
- Dementia, Humans, Parkinson Disease
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