Diagnosis and management of dementia with lewy bodies : Third report of the DLB consortium
Identifieur interne : 000868 ( PascalFrancis/Corpus ); précédent : 000867; suivant : 000869Diagnosis and management of dementia with lewy bodies : Third report of the DLB consortium
Auteurs : 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 ; D. Aarsland ; H. Arai ; C. G. Ballard ; B. Boeve ; D. J. Burn ; D. Costa ; T. Del Ser ; B. Duboi ; D. Galasko ; S. Gauthier ; C. G. Goetz ; E. Gomez-Tortos ; F. G. Halliday ; L. A. Hansen ; J. Hardy ; T. Iwatsubo ; R. N. Kalaria ; D. Kaufer ; R. A. Kenny ; A. Korczyn ; K. Kosaka ; V. M.-Y. Lee ; A. Lees ; I. Litvan ; E. Londos ; O. L. Lopez ; S. Minoshima ; Y. Mizuno ; J. A. Molina ; E. B. Mukaetova-Ladinska ; F. Pasquier ; R. H. Perry ; J. B. Schulz ; J. Q. Trojanowski ; M. YamadaSource :
- Neurology [ 0028-3878 ] ; 2005.
Descripteurs français
- Pascal (Inist)
English descriptors
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 ∼50%, and improvements in attention, visual hallucinations, and sleep disorders with cholinesterase inhibitors.
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Pour connaître la documentation sur le format Inist Standard.
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Format Inist (serveur)
| NO : | PASCAL 06-0077698 INIST |
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| ET : | Diagnosis and management of dementia with lewy bodies : Third report of the DLB consortium |
| AU : | MCKEITH (I. G.); DICKSON (D. W.); LOWE (J.); EMRE (M.); O'BRIEN (J. T.); FELDMAN (H.); CUMMINGS (J.); DUDA (J. E.); LIPPA (C.); PERRY (E. K.); AARSLAND (D.); ARAI (H.); BALLARD (C. G.); BOEVE (B.); BURN (D. J.); COSTA (D.); DEL SER (T.); DUBOI (B.); GALASKO (D.); GAUTHIER (S.); GOETZ (C. G.); GOMEZ-TORTOS (E.); HALLIDAY (F. G.); HANSEN (L. A.); HARDY (J.); IWATSUBO (T.); KALARIA (R. N.); KAUFER (D.); KENNY (R. A.); KORCZYN (A.); KOSAKA (K.); LEE (V. M.-Y.); LEES (A.); LITVAN (I.); LONDOS (E.); LOPEZ (O. L.); MINOSHIMA (S.); MIZUNO (Y.); MOLINA (J. A.); MUKAETOVA-LADINSKA (E. B.); PASQUIER (F.); PERRY (R. H.); SCHULZ (J. B.); TROJANOWSKI (J. Q.); YAMADA (M.) |
| AF : | Institute for Ageing and Health, University of Newcastle upon Tyne/Royaume-Uni (1 aut., 5 aut., 10 aut., 15 aut., 27 aut., 29 aut., 40 aut., 42 aut.); Department of Neuropathology, Mayo Clinic/Jacksonville, FL/Etats-Unis (2 aut.); Division of Pathology, School of Molecular Medical Sciences, University of Nottingham/Royaume-Uni (3 aut.); Department of Neurology, Istanbul University, Istanbul Faculty of Medicine/Turquie (4 aut.); UBC Division of Neurology, University of British Columbia/Vancouver/Canada (6 aut.); Department of Neurology, UCLA Medical School Alzheimer's Disease Center/Los Angeles, CA/Etats-Unis (7 aut.); Parkinson's Disease Research, Education and Clinical Center, Philadelphia VAMC/PA/Etats-Unis (8 aut.); Memory Disorders Program, Drexel University School of Medicine/Philadelphia, PA/Etats-Unis (9 aut.); Section of Geriatric Psychiatry, Stavanger University Hospital/Norvège (11 aut.); Department of Geriatric & Respiratory Medicine, Tohoku University School of Medicine/Miyagi/Japon (12 aut.); Wolfson Centre for Age-Related Diseases/London/Royaume-Uni (13 aut.); Department of Neurology, Mayo Clinic/Rochester, MN/Etats-Unis (14 aut.); Institute of Nuclear Medicine, HPP Medicina Molecular, SA/Porto/Portugal (16 aut.); Section of Neurology, Hospital Severo Ochoa/Madrid/Espagne (17 aut.); Hopital La Salpêtnère/Paris/France (18 aut.); Dept. of Neuroscience, University of California San Diego/La Jolla/Etats-Unis (19 aut.); MCSA Alzheimer's Disease Research Unit, McGill Centre for Studies in Aging/Quebec/Canada (20 aut.); Department of Neurological Sciences, Rush University Medical Center/Chicago, IL/Etats-Unis (21 aut.); Fundación Jiménez Diaz, Servicio de Neurología/Madrid/Espagne (22 aut.); Prince of Wales Medical Research Institute/Sydney/Australie (23 aut.); Dept. of Pathology, University of California San Diego/La Jolla/Etats-Unis (24 aut.); Laboratory of Neurogenetics, National Institute on Aging/Bethesda, MD/Etats-Unis (25 aut.); Department of Neuropathology & Neuroscience, University of Tokyo/Japon (26 aut.); Dept. of Neurology CB 7025, University of North Carolina School of Medicine/Chapel Hill/Etats-Unis (28 aut.); Department of Neurology, Tel-Aviv University/Israël (30 aut.) |
| DT : | Publication en série; Niveau analytique |
| SO : | Neurology; ISSN 0028-3878; Coden NEURAI; Etats-Unis; Da. 2005; Vol. 65; No. 12; Pp. 1863-1872; Bibl. 105 ref. |
| LA : | Anglais |
| EA : | 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 ∼50%, and improvements in attention, visual hallucinations, and sleep disorders with cholinesterase inhibitors. |
| CC : | 002B17; 002B17G; 002B17E |
| FD : | Système nerveux pathologie; Diagnostic; Conduite à tenir; Démence corps Lewy |
| ED : | Nervous system diseases; Diagnosis; Clinical management; Lewy body dementia |
| SD : | Sistema nervioso patología; Diagnóstico; Actitud médica; Demencia cuerpos Lewy |
| LO : | INIST-6345.354000134375700040 |
| ID : | 06-0077698 |
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Pascal:06-0077698Le document en format XML
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Hansen</name><affiliation><inist:fA14 i1="21"><s1>Dept. of Pathology, University of California San Diego</s1><s2>La Jolla</s2><s3>USA</s3><sZ>24 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Hardy, J" sort="Hardy, J" uniqKey="Hardy J" first="J." last="Hardy">J. Hardy</name><affiliation><inist:fA14 i1="22"><s1>Laboratory of Neurogenetics, National Institute on Aging</s1><s2>Bethesda, MD</s2><s3>USA</s3><sZ>25 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Iwatsubo, T" sort="Iwatsubo, T" uniqKey="Iwatsubo T" first="T." last="Iwatsubo">T. Iwatsubo</name><affiliation><inist:fA14 i1="23"><s1>Department of Neuropathology & Neuroscience, University of Tokyo</s1><s3>JPN</s3><sZ>26 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Kalaria, R N" sort="Kalaria, R N" uniqKey="Kalaria R" first="R. N." last="Kalaria">R. N. Kalaria</name><affiliation><inist:fA14 i1="01"><s1>Institute for Ageing and Health, University of Newcastle upon Tyne</s1><s3>GBR</s3><sZ>1 aut.</sZ><sZ>5 aut.</sZ><sZ>10 aut.</sZ><sZ>15 aut.</sZ><sZ>27 aut.</sZ><sZ>29 aut.</sZ><sZ>40 aut.</sZ><sZ>42 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Kaufer, D" sort="Kaufer, D" uniqKey="Kaufer D" first="D." last="Kaufer">D. Kaufer</name><affiliation><inist:fA14 i1="24"><s1>Dept. of Neurology CB 7025, University of North Carolina School of Medicine</s1><s2>Chapel Hill</s2><s3>USA</s3><sZ>28 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Kenny, R A" sort="Kenny, R A" uniqKey="Kenny R" first="R. A." last="Kenny">R. A. Kenny</name><affiliation><inist:fA14 i1="01"><s1>Institute for Ageing and Health, University of Newcastle upon Tyne</s1><s3>GBR</s3><sZ>1 aut.</sZ><sZ>5 aut.</sZ><sZ>10 aut.</sZ><sZ>15 aut.</sZ><sZ>27 aut.</sZ><sZ>29 aut.</sZ><sZ>40 aut.</sZ><sZ>42 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Korczyn, A" sort="Korczyn, A" uniqKey="Korczyn A" first="A." last="Korczyn">A. Korczyn</name><affiliation><inist:fA14 i1="25"><s1>Department of Neurology, Tel-Aviv University</s1><s3>ISR</s3><sZ>30 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Kosaka, K" sort="Kosaka, K" uniqKey="Kosaka K" first="K." last="Kosaka">K. Kosaka</name></author><author><name sortKey="Lee, V M Y" sort="Lee, V M Y" uniqKey="Lee V" first="V. M.-Y." last="Lee">V. M.-Y. Lee</name></author><author><name sortKey="Lees, A" sort="Lees, A" uniqKey="Lees A" first="A." last="Lees">A. Lees</name></author><author><name sortKey="Litvan, I" sort="Litvan, I" uniqKey="Litvan I" first="I." last="Litvan">I. Litvan</name></author><author><name sortKey="Londos, E" sort="Londos, E" uniqKey="Londos E" first="E." last="Londos">E. Londos</name></author><author><name sortKey="Lopez, O L" sort="Lopez, O L" uniqKey="Lopez O" first="O. L." last="Lopez">O. L. Lopez</name></author><author><name sortKey="Minoshima, S" sort="Minoshima, S" uniqKey="Minoshima S" first="S." last="Minoshima">S. Minoshima</name></author><author><name sortKey="Mizuno, Y" sort="Mizuno, Y" uniqKey="Mizuno Y" first="Y." last="Mizuno">Y. Mizuno</name></author><author><name sortKey="Molina, J A" sort="Molina, J A" uniqKey="Molina J" first="J. A." last="Molina">J. A. Molina</name></author><author><name sortKey="Mukaetova Ladinska, E B" sort="Mukaetova Ladinska, E B" uniqKey="Mukaetova Ladinska E" first="E. B." last="Mukaetova-Ladinska">E. B. Mukaetova-Ladinska</name><affiliation><inist:fA14 i1="01"><s1>Institute for Ageing and Health, University of Newcastle upon Tyne</s1><s3>GBR</s3><sZ>1 aut.</sZ><sZ>5 aut.</sZ><sZ>10 aut.</sZ><sZ>15 aut.</sZ><sZ>27 aut.</sZ><sZ>29 aut.</sZ><sZ>40 aut.</sZ><sZ>42 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Pasquier, F" sort="Pasquier, F" uniqKey="Pasquier F" first="F." last="Pasquier">F. Pasquier</name></author><author><name sortKey="Perry, R H" sort="Perry, R H" uniqKey="Perry R" first="R. H." last="Perry">R. H. Perry</name><affiliation><inist:fA14 i1="01"><s1>Institute for Ageing and Health, University of Newcastle upon Tyne</s1><s3>GBR</s3><sZ>1 aut.</sZ><sZ>5 aut.</sZ><sZ>10 aut.</sZ><sZ>15 aut.</sZ><sZ>27 aut.</sZ><sZ>29 aut.</sZ><sZ>40 aut.</sZ><sZ>42 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Schulz, J B" sort="Schulz, J B" uniqKey="Schulz J" first="J. B." last="Schulz">J. B. Schulz</name></author><author><name sortKey="Trojanowski, J Q" sort="Trojanowski, J Q" uniqKey="Trojanowski J" first="J. Q." last="Trojanowski">J. Q. Trojanowski</name></author><author><name sortKey="Yamada, M" sort="Yamada, M" uniqKey="Yamada M" first="M." last="Yamada">M. Yamada</name></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">06-0077698</idno><date when="2005">2005</date><idno type="stanalyst">PASCAL 06-0077698 INIST</idno><idno type="RBID">Pascal:06-0077698</idno><idno type="wicri:Area/PascalFrancis/Corpus">000868</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Diagnosis and management of dementia with lewy bodies : Third report of the DLB consortium</title><author><name sortKey="Mckeith, I G" sort="Mckeith, I G" uniqKey="Mckeith I" first="I. G." last="Mckeith">I. G. Mckeith</name><affiliation><inist:fA14 i1="01"><s1>Institute for Ageing and Health, University of Newcastle upon Tyne</s1><s3>GBR</s3><sZ>1 aut.</sZ><sZ>5 aut.</sZ><sZ>10 aut.</sZ><sZ>15 aut.</sZ><sZ>27 aut.</sZ><sZ>29 aut.</sZ><sZ>40 aut.</sZ><sZ>42 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Dickson, D W" sort="Dickson, D W" uniqKey="Dickson D" first="D. W." last="Dickson">D. W. Dickson</name><affiliation><inist:fA14 i1="02"><s1>Department of Neuropathology, Mayo Clinic</s1><s2>Jacksonville, FL</s2><s3>USA</s3><sZ>2 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Lowe, J" sort="Lowe, J" uniqKey="Lowe J" first="J." last="Lowe">J. Lowe</name><affiliation><inist:fA14 i1="03"><s1>Division of Pathology, School of Molecular Medical Sciences, University of Nottingham</s1><s3>GBR</s3><sZ>3 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Emre, M" sort="Emre, M" uniqKey="Emre M" first="M." last="Emre">M. Emre</name><affiliation><inist:fA14 i1="04"><s1>Department of Neurology, Istanbul University, Istanbul Faculty of Medicine</s1><s3>TUR</s3><sZ>4 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="O Brien, J T" sort="O Brien, J T" uniqKey="O Brien J" first="J. T." last="O'Brien">J. T. O'Brien</name><affiliation><inist:fA14 i1="01"><s1>Institute for Ageing and Health, University of Newcastle upon Tyne</s1><s3>GBR</s3><sZ>1 aut.</sZ><sZ>5 aut.</sZ><sZ>10 aut.</sZ><sZ>15 aut.</sZ><sZ>27 aut.</sZ><sZ>29 aut.</sZ><sZ>40 aut.</sZ><sZ>42 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Feldman, H" sort="Feldman, H" uniqKey="Feldman H" first="H." last="Feldman">H. Feldman</name><affiliation><inist:fA14 i1="05"><s1>UBC Division of Neurology, University of British Columbia</s1><s2>Vancouver</s2><s3>CAN</s3><sZ>6 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Cummings, J" sort="Cummings, J" uniqKey="Cummings J" first="J." last="Cummings">J. Cummings</name><affiliation><inist:fA14 i1="06"><s1>Department of Neurology, UCLA Medical School Alzheimer's Disease Center</s1><s2>Los Angeles, CA</s2><s3>USA</s3><sZ>7 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Duda, J E" sort="Duda, J E" uniqKey="Duda J" first="J. E." last="Duda">J. E. Duda</name><affiliation><inist:fA14 i1="07"><s1>Parkinson's Disease Research, Education and Clinical Center, Philadelphia VAMC</s1><s2>PA</s2><s3>USA</s3><sZ>8 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Lippa, C" sort="Lippa, C" uniqKey="Lippa C" first="C." last="Lippa">C. Lippa</name><affiliation><inist:fA14 i1="08"><s1>Memory Disorders Program, Drexel University School of Medicine</s1><s2>Philadelphia, PA</s2><s3>USA</s3><sZ>9 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Perry, E K" sort="Perry, E K" uniqKey="Perry E" first="E. K." last="Perry">E. K. Perry</name><affiliation><inist:fA14 i1="01"><s1>Institute for Ageing and Health, University of Newcastle upon Tyne</s1><s3>GBR</s3><sZ>1 aut.</sZ><sZ>5 aut.</sZ><sZ>10 aut.</sZ><sZ>15 aut.</sZ><sZ>27 aut.</sZ><sZ>29 aut.</sZ><sZ>40 aut.</sZ><sZ>42 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Aarsland, D" sort="Aarsland, D" uniqKey="Aarsland D" first="D." last="Aarsland">D. Aarsland</name><affiliation><inist:fA14 i1="09"><s1>Section of Geriatric Psychiatry, Stavanger University Hospital</s1><s3>NOR</s3><sZ>11 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Arai, H" sort="Arai, H" uniqKey="Arai H" first="H." last="Arai">H. Arai</name><affiliation><inist:fA14 i1="10"><s1>Department of Geriatric & Respiratory Medicine, Tohoku University School of Medicine</s1><s2>Miyagi</s2><s3>JPN</s3><sZ>12 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Ballard, C G" sort="Ballard, C G" uniqKey="Ballard C" first="C. G." last="Ballard">C. G. Ballard</name><affiliation><inist:fA14 i1="11"><s1>Wolfson Centre for Age-Related Diseases</s1><s2>London</s2><s3>GBR</s3><sZ>13 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Boeve, B" sort="Boeve, B" uniqKey="Boeve B" first="B." last="Boeve">B. Boeve</name><affiliation><inist:fA14 i1="12"><s1>Department of Neurology, Mayo Clinic</s1><s2>Rochester, MN</s2><s3>USA</s3><sZ>14 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Burn, D J" sort="Burn, D J" uniqKey="Burn D" first="D. J." last="Burn">D. J. Burn</name><affiliation><inist:fA14 i1="01"><s1>Institute for Ageing and Health, University of Newcastle upon Tyne</s1><s3>GBR</s3><sZ>1 aut.</sZ><sZ>5 aut.</sZ><sZ>10 aut.</sZ><sZ>15 aut.</sZ><sZ>27 aut.</sZ><sZ>29 aut.</sZ><sZ>40 aut.</sZ><sZ>42 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Costa, D" sort="Costa, D" uniqKey="Costa D" first="D." last="Costa">D. Costa</name><affiliation><inist:fA14 i1="13"><s1>Institute of Nuclear Medicine, HPP Medicina Molecular, SA</s1><s2>Porto</s2><s3>PRT</s3><sZ>16 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Del Ser, T" sort="Del Ser, T" uniqKey="Del Ser T" first="T." last="Del Ser">T. Del Ser</name><affiliation><inist:fA14 i1="14"><s1>Section of Neurology, Hospital Severo Ochoa</s1><s2>Madrid</s2><s3>ESP</s3><sZ>17 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Duboi, B" sort="Duboi, B" uniqKey="Duboi B" first="B." last="Duboi">B. Duboi</name><affiliation><inist:fA14 i1="15"><s1>Hopital La Salpêtnère</s1><s2>Paris</s2><s3>FRA</s3><sZ>18 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Galasko, D" sort="Galasko, D" uniqKey="Galasko D" first="D." last="Galasko">D. Galasko</name><affiliation><inist:fA14 i1="16"><s1>Dept. of Neuroscience, University of California San Diego</s1><s2>La Jolla</s2><s3>USA</s3><sZ>19 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Gauthier, S" sort="Gauthier, S" uniqKey="Gauthier S" first="S." last="Gauthier">S. Gauthier</name><affiliation><inist:fA14 i1="17"><s1>MCSA Alzheimer's Disease Research Unit, McGill Centre for Studies in Aging</s1><s2>Quebec</s2><s3>CAN</s3><sZ>20 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Goetz, C G" sort="Goetz, C G" uniqKey="Goetz C" first="C. G." last="Goetz">C. G. Goetz</name><affiliation><inist:fA14 i1="18"><s1>Department of Neurological Sciences, Rush University Medical Center</s1><s2>Chicago, IL</s2><s3>USA</s3><sZ>21 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Gomez Tortos, E" sort="Gomez Tortos, E" uniqKey="Gomez Tortos E" first="E." last="Gomez-Tortos">E. Gomez-Tortos</name><affiliation><inist:fA14 i1="19"><s1>Fundación Jiménez Diaz, Servicio de Neurología</s1><s2>Madrid</s2><s3>ESP</s3><sZ>22 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Halliday, F G" sort="Halliday, F G" uniqKey="Halliday F" first="F. G." last="Halliday">F. G. Halliday</name><affiliation><inist:fA14 i1="20"><s1>Prince of Wales Medical Research Institute</s1><s2>Sydney</s2><s3>AUS</s3><sZ>23 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Hansen, L A" sort="Hansen, L A" uniqKey="Hansen L" first="L. A." last="Hansen">L. A. Hansen</name><affiliation><inist:fA14 i1="21"><s1>Dept. of Pathology, University of California San Diego</s1><s2>La Jolla</s2><s3>USA</s3><sZ>24 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Hardy, J" sort="Hardy, J" uniqKey="Hardy J" first="J." last="Hardy">J. Hardy</name><affiliation><inist:fA14 i1="22"><s1>Laboratory of Neurogenetics, National Institute on Aging</s1><s2>Bethesda, MD</s2><s3>USA</s3><sZ>25 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Iwatsubo, T" sort="Iwatsubo, T" uniqKey="Iwatsubo T" first="T." last="Iwatsubo">T. Iwatsubo</name><affiliation><inist:fA14 i1="23"><s1>Department of Neuropathology & Neuroscience, University of Tokyo</s1><s3>JPN</s3><sZ>26 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Kalaria, R N" sort="Kalaria, R N" uniqKey="Kalaria R" first="R. N." last="Kalaria">R. N. Kalaria</name><affiliation><inist:fA14 i1="01"><s1>Institute for Ageing and Health, University of Newcastle upon Tyne</s1><s3>GBR</s3><sZ>1 aut.</sZ><sZ>5 aut.</sZ><sZ>10 aut.</sZ><sZ>15 aut.</sZ><sZ>27 aut.</sZ><sZ>29 aut.</sZ><sZ>40 aut.</sZ><sZ>42 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Kaufer, D" sort="Kaufer, D" uniqKey="Kaufer D" first="D." last="Kaufer">D. Kaufer</name><affiliation><inist:fA14 i1="24"><s1>Dept. of Neurology CB 7025, University of North Carolina School of Medicine</s1><s2>Chapel Hill</s2><s3>USA</s3><sZ>28 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Kenny, R A" sort="Kenny, R A" uniqKey="Kenny R" first="R. A." last="Kenny">R. A. Kenny</name><affiliation><inist:fA14 i1="01"><s1>Institute for Ageing and Health, University of Newcastle upon Tyne</s1><s3>GBR</s3><sZ>1 aut.</sZ><sZ>5 aut.</sZ><sZ>10 aut.</sZ><sZ>15 aut.</sZ><sZ>27 aut.</sZ><sZ>29 aut.</sZ><sZ>40 aut.</sZ><sZ>42 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Korczyn, A" sort="Korczyn, A" uniqKey="Korczyn A" first="A." last="Korczyn">A. Korczyn</name><affiliation><inist:fA14 i1="25"><s1>Department of Neurology, Tel-Aviv University</s1><s3>ISR</s3><sZ>30 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Kosaka, K" sort="Kosaka, K" uniqKey="Kosaka K" first="K." last="Kosaka">K. Kosaka</name></author><author><name sortKey="Lee, V M Y" sort="Lee, V M Y" uniqKey="Lee V" first="V. M.-Y." last="Lee">V. M.-Y. Lee</name></author><author><name sortKey="Lees, A" sort="Lees, A" uniqKey="Lees A" first="A." last="Lees">A. Lees</name></author><author><name sortKey="Litvan, I" sort="Litvan, I" uniqKey="Litvan I" first="I." last="Litvan">I. Litvan</name></author><author><name sortKey="Londos, E" sort="Londos, E" uniqKey="Londos E" first="E." last="Londos">E. Londos</name></author><author><name sortKey="Lopez, O L" sort="Lopez, O L" uniqKey="Lopez O" first="O. L." last="Lopez">O. L. Lopez</name></author><author><name sortKey="Minoshima, S" sort="Minoshima, S" uniqKey="Minoshima S" first="S." last="Minoshima">S. Minoshima</name></author><author><name sortKey="Mizuno, Y" sort="Mizuno, Y" uniqKey="Mizuno Y" first="Y." last="Mizuno">Y. Mizuno</name></author><author><name sortKey="Molina, J A" sort="Molina, J A" uniqKey="Molina J" first="J. A." last="Molina">J. A. Molina</name></author><author><name sortKey="Mukaetova Ladinska, E B" sort="Mukaetova Ladinska, E B" uniqKey="Mukaetova Ladinska E" first="E. B." last="Mukaetova-Ladinska">E. B. Mukaetova-Ladinska</name><affiliation><inist:fA14 i1="01"><s1>Institute for Ageing and Health, University of Newcastle upon Tyne</s1><s3>GBR</s3><sZ>1 aut.</sZ><sZ>5 aut.</sZ><sZ>10 aut.</sZ><sZ>15 aut.</sZ><sZ>27 aut.</sZ><sZ>29 aut.</sZ><sZ>40 aut.</sZ><sZ>42 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Pasquier, F" sort="Pasquier, F" uniqKey="Pasquier F" first="F." last="Pasquier">F. Pasquier</name></author><author><name sortKey="Perry, R H" sort="Perry, R H" uniqKey="Perry R" first="R. H." last="Perry">R. H. Perry</name><affiliation><inist:fA14 i1="01"><s1>Institute for Ageing and Health, University of Newcastle upon Tyne</s1><s3>GBR</s3><sZ>1 aut.</sZ><sZ>5 aut.</sZ><sZ>10 aut.</sZ><sZ>15 aut.</sZ><sZ>27 aut.</sZ><sZ>29 aut.</sZ><sZ>40 aut.</sZ><sZ>42 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Schulz, J B" sort="Schulz, J B" uniqKey="Schulz J" first="J. B." last="Schulz">J. B. Schulz</name></author><author><name sortKey="Trojanowski, J Q" sort="Trojanowski, J Q" uniqKey="Trojanowski J" first="J. Q." last="Trojanowski">J. Q. Trojanowski</name></author><author><name sortKey="Yamada, M" sort="Yamada, M" uniqKey="Yamada M" first="M." last="Yamada">M. Yamada</name></author></analytic><series><title level="j" type="main">Neurology</title><title level="j" type="abbreviated">Neurology</title><idno type="ISSN">0028-3878</idno><imprint><date when="2005">2005</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Neurology</title><title level="j" type="abbreviated">Neurology</title><idno type="ISSN">0028-3878</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Clinical management</term><term>Diagnosis</term><term>Lewy body dementia</term><term>Nervous system diseases</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Système nerveux pathologie</term><term>Diagnostic</term><term>Conduite à tenir</term><term>Démence corps Lewy</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">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 ∼50%, and improvements in attention, visual hallucinations, and sleep disorders with cholinesterase inhibitors.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0028-3878</s0></fA01><fA02 i1="01"><s0>NEURAI</s0></fA02><fA03 i2="1"><s0>Neurology</s0></fA03><fA05><s2>65</s2></fA05><fA06><s2>12</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Diagnosis and management of dementia with lewy bodies : Third report of the DLB consortium</s1></fA08><fA11 i1="01" i2="1"><s1>MCKEITH (I. G.)</s1></fA11><fA11 i1="02" i2="1"><s1>DICKSON (D. W.)</s1></fA11><fA11 i1="03" i2="1"><s1>LOWE (J.)</s1></fA11><fA11 i1="04" i2="1"><s1>EMRE (M.)</s1></fA11><fA11 i1="05" i2="1"><s1>O'BRIEN (J. T.)</s1></fA11><fA11 i1="06" i2="1"><s1>FELDMAN (H.)</s1></fA11><fA11 i1="07" i2="1"><s1>CUMMINGS (J.)</s1></fA11><fA11 i1="08" i2="1"><s1>DUDA (J. E.)</s1></fA11><fA11 i1="09" i2="1"><s1>LIPPA (C.)</s1></fA11><fA11 i1="10" i2="1"><s1>PERRY (E. K.)</s1></fA11><fA11 i1="11" i2="1"><s1>AARSLAND (D.)</s1></fA11><fA11 i1="12" i2="1"><s1>ARAI (H.)</s1></fA11><fA11 i1="13" i2="1"><s1>BALLARD (C. G.)</s1></fA11><fA11 i1="14" i2="1"><s1>BOEVE (B.)</s1></fA11><fA11 i1="15" i2="1"><s1>BURN (D. J.)</s1></fA11><fA11 i1="16" i2="1"><s1>COSTA (D.)</s1></fA11><fA11 i1="17" i2="1"><s1>DEL SER (T.)</s1></fA11><fA11 i1="18" i2="1"><s1>DUBOI (B.)</s1></fA11><fA11 i1="19" i2="1"><s1>GALASKO (D.)</s1></fA11><fA11 i1="20" i2="1"><s1>GAUTHIER (S.)</s1></fA11><fA11 i1="21" i2="1"><s1>GOETZ (C. G.)</s1></fA11><fA11 i1="22" i2="1"><s1>GOMEZ-TORTOS (E.)</s1></fA11><fA11 i1="23" i2="1"><s1>HALLIDAY (F. G.)</s1></fA11><fA11 i1="24" i2="1"><s1>HANSEN (L. A.)</s1></fA11><fA11 i1="25" i2="1"><s1>HARDY (J.)</s1></fA11><fA11 i1="26" i2="1"><s1>IWATSUBO (T.)</s1></fA11><fA11 i1="27" i2="1"><s1>KALARIA (R. N.)</s1></fA11><fA11 i1="28" i2="1"><s1>KAUFER (D.)</s1></fA11><fA11 i1="29" i2="1"><s1>KENNY (R. A.)</s1></fA11><fA11 i1="30" i2="1"><s1>KORCZYN (A.)</s1></fA11><fA11 i1="31" i2="1"><s1>KOSAKA (K.)</s1></fA11><fA11 i1="32" i2="1"><s1>LEE (V. M.-Y.)</s1></fA11><fA11 i1="33" i2="1"><s1>LEES (A.)</s1></fA11><fA11 i1="34" i2="1"><s1>LITVAN (I.)</s1></fA11><fA11 i1="35" i2="1"><s1>LONDOS (E.)</s1></fA11><fA11 i1="36" i2="1"><s1>LOPEZ (O. L.)</s1></fA11><fA11 i1="37" i2="1"><s1>MINOSHIMA (S.)</s1></fA11><fA11 i1="38" i2="1"><s1>MIZUNO (Y.)</s1></fA11><fA11 i1="39" i2="1"><s1>MOLINA (J. A.)</s1></fA11><fA11 i1="40" i2="1"><s1>MUKAETOVA-LADINSKA (E. B.)</s1></fA11><fA11 i1="41" i2="1"><s1>PASQUIER (F.)</s1></fA11><fA11 i1="42" i2="1"><s1>PERRY (R. H.)</s1></fA11><fA11 i1="43" i2="1"><s1>SCHULZ (J. B.)</s1></fA11><fA11 i1="44" i2="1"><s1>TROJANOWSKI (J. Q.)</s1></fA11><fA11 i1="45" i2="1"><s1>YAMADA (M.)</s1></fA11><fA14 i1="01"><s1>Institute for Ageing and Health, University of Newcastle upon Tyne</s1><s3>GBR</s3><sZ>1 aut.</sZ><sZ>5 aut.</sZ><sZ>10 aut.</sZ><sZ>15 aut.</sZ><sZ>27 aut.</sZ><sZ>29 aut.</sZ><sZ>40 aut.</sZ><sZ>42 aut.</sZ></fA14><fA14 i1="02"><s1>Department of Neuropathology, Mayo Clinic</s1><s2>Jacksonville, FL</s2><s3>USA</s3><sZ>2 aut.</sZ></fA14><fA14 i1="03"><s1>Division of Pathology, School of Molecular Medical Sciences, University of Nottingham</s1><s3>GBR</s3><sZ>3 aut.</sZ></fA14><fA14 i1="04"><s1>Department of Neurology, Istanbul University, Istanbul Faculty of Medicine</s1><s3>TUR</s3><sZ>4 aut.</sZ></fA14><fA14 i1="05"><s1>UBC Division of Neurology, University of British Columbia</s1><s2>Vancouver</s2><s3>CAN</s3><sZ>6 aut.</sZ></fA14><fA14 i1="06"><s1>Department of Neurology, UCLA Medical School Alzheimer's Disease Center</s1><s2>Los Angeles, CA</s2><s3>USA</s3><sZ>7 aut.</sZ></fA14><fA14 i1="07"><s1>Parkinson's Disease Research, Education and Clinical Center, Philadelphia VAMC</s1><s2>PA</s2><s3>USA</s3><sZ>8 aut.</sZ></fA14><fA14 i1="08"><s1>Memory Disorders Program, Drexel University School of Medicine</s1><s2>Philadelphia, PA</s2><s3>USA</s3><sZ>9 aut.</sZ></fA14><fA14 i1="09"><s1>Section of Geriatric Psychiatry, Stavanger University Hospital</s1><s3>NOR</s3><sZ>11 aut.</sZ></fA14><fA14 i1="10"><s1>Department of Geriatric & Respiratory Medicine, Tohoku University School of Medicine</s1><s2>Miyagi</s2><s3>JPN</s3><sZ>12 aut.</sZ></fA14><fA14 i1="11"><s1>Wolfson Centre for Age-Related Diseases</s1><s2>London</s2><s3>GBR</s3><sZ>13 aut.</sZ></fA14><fA14 i1="12"><s1>Department of Neurology, Mayo Clinic</s1><s2>Rochester, MN</s2><s3>USA</s3><sZ>14 aut.</sZ></fA14><fA14 i1="13"><s1>Institute of Nuclear Medicine, HPP Medicina Molecular, SA</s1><s2>Porto</s2><s3>PRT</s3><sZ>16 aut.</sZ></fA14><fA14 i1="14"><s1>Section of Neurology, Hospital Severo Ochoa</s1><s2>Madrid</s2><s3>ESP</s3><sZ>17 aut.</sZ></fA14><fA14 i1="15"><s1>Hopital La Salpêtnère</s1><s2>Paris</s2><s3>FRA</s3><sZ>18 aut.</sZ></fA14><fA14 i1="16"><s1>Dept. of Neuroscience, University of California San Diego</s1><s2>La Jolla</s2><s3>USA</s3><sZ>19 aut.</sZ></fA14><fA14 i1="17"><s1>MCSA Alzheimer's Disease Research Unit, McGill Centre for Studies in Aging</s1><s2>Quebec</s2><s3>CAN</s3><sZ>20 aut.</sZ></fA14><fA14 i1="18"><s1>Department of Neurological Sciences, Rush University Medical Center</s1><s2>Chicago, IL</s2><s3>USA</s3><sZ>21 aut.</sZ></fA14><fA14 i1="19"><s1>Fundación Jiménez Diaz, Servicio de Neurología</s1><s2>Madrid</s2><s3>ESP</s3><sZ>22 aut.</sZ></fA14><fA14 i1="20"><s1>Prince of Wales Medical Research Institute</s1><s2>Sydney</s2><s3>AUS</s3><sZ>23 aut.</sZ></fA14><fA14 i1="21"><s1>Dept. of Pathology, University of California San Diego</s1><s2>La Jolla</s2><s3>USA</s3><sZ>24 aut.</sZ></fA14><fA14 i1="22"><s1>Laboratory of Neurogenetics, National Institute on Aging</s1><s2>Bethesda, MD</s2><s3>USA</s3><sZ>25 aut.</sZ></fA14><fA14 i1="23"><s1>Department of Neuropathology & Neuroscience, University of Tokyo</s1><s3>JPN</s3><sZ>26 aut.</sZ></fA14><fA14 i1="24"><s1>Dept. of Neurology CB 7025, University of North Carolina School of Medicine</s1><s2>Chapel Hill</s2><s3>USA</s3><sZ>28 aut.</sZ></fA14><fA14 i1="25"><s1>Department of Neurology, Tel-Aviv University</s1><s3>ISR</s3><sZ>30 aut.</sZ></fA14><fA17 i1="01" i2="1"><s1>the Consortium on DL</s1><s3>INC</s3></fA17><fA20><s1>1863-1872</s1></fA20><fA21><s1>2005</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>6345</s2><s5>354000134375700040</s5></fA43><fA44><s0>0000</s0><s1>© 2006 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>105 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>06-0077698</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Neurology</s0></fA64><fA66 i1="01"><s0>USA</s0></fA66><fC01 i1="01" l="ENG"><s0>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 ∼50%, and improvements in attention, visual hallucinations, and sleep disorders with cholinesterase inhibitors.</s0></fC01><fC02 i1="01" i2="X"><s0>002B17</s0></fC02><fC02 i1="02" i2="X"><s0>002B17G</s0></fC02><fC02 i1="03" i2="X"><s0>002B17E</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Système nerveux pathologie</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Nervous system diseases</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Sistema nervioso patología</s0><s5>01</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Diagnostic</s0><s5>09</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Diagnosis</s0><s5>09</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Diagnóstico</s0><s5>09</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Conduite à tenir</s0><s5>10</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Clinical management</s0><s5>10</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Actitud médica</s0><s5>10</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Démence corps Lewy</s0><s2>NM</s2><s5>11</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Lewy body dementia</s0><s2>NM</s2><s5>11</s5></fC03><fC03 i1="04" i2="X" l="SPA"><s0>Demencia cuerpos Lewy</s0><s2>NM</s2><s5>11</s5></fC03><fN21><s1>044</s1></fN21><fN44 i1="01"><s1>OTO</s1></fN44><fN82><s1>OTO</s1></fN82></pA></standard><server><NO>PASCAL 06-0077698 INIST</NO><ET>Diagnosis and management of dementia with lewy bodies : Third report of the DLB consortium</ET><AU>MCKEITH (I. G.); DICKSON (D. W.); LOWE (J.); EMRE (M.); O'BRIEN (J. T.); FELDMAN (H.); CUMMINGS (J.); DUDA (J. E.); LIPPA (C.); PERRY (E. K.); AARSLAND (D.); ARAI (H.); BALLARD (C. G.); BOEVE (B.); BURN (D. J.); COSTA (D.); DEL SER (T.); DUBOI (B.); GALASKO (D.); GAUTHIER (S.); GOETZ (C. G.); GOMEZ-TORTOS (E.); HALLIDAY (F. G.); HANSEN (L. A.); HARDY (J.); IWATSUBO (T.); KALARIA (R. N.); KAUFER (D.); KENNY (R. A.); KORCZYN (A.); KOSAKA (K.); LEE (V. M.-Y.); LEES (A.); LITVAN (I.); LONDOS (E.); LOPEZ (O. L.); MINOSHIMA (S.); MIZUNO (Y.); MOLINA (J. A.); MUKAETOVA-LADINSKA (E. B.); PASQUIER (F.); PERRY (R. H.); SCHULZ (J. B.); TROJANOWSKI (J. Q.); YAMADA (M.)</AU><AF>Institute for Ageing and Health, University of Newcastle upon Tyne/Royaume-Uni (1 aut., 5 aut., 10 aut., 15 aut., 27 aut., 29 aut., 40 aut., 42 aut.); Department of Neuropathology, Mayo Clinic/Jacksonville, FL/Etats-Unis (2 aut.); Division of Pathology, School of Molecular Medical Sciences, University of Nottingham/Royaume-Uni (3 aut.); Department of Neurology, Istanbul University, Istanbul Faculty of Medicine/Turquie (4 aut.); UBC Division of Neurology, University of British Columbia/Vancouver/Canada (6 aut.); Department of Neurology, UCLA Medical School Alzheimer's Disease Center/Los Angeles, CA/Etats-Unis (7 aut.); Parkinson's Disease Research, Education and Clinical Center, Philadelphia VAMC/PA/Etats-Unis (8 aut.); Memory Disorders Program, Drexel University School of Medicine/Philadelphia, PA/Etats-Unis (9 aut.); Section of Geriatric Psychiatry, Stavanger University Hospital/Norvège (11 aut.); Department of Geriatric & Respiratory Medicine, Tohoku University School of Medicine/Miyagi/Japon (12 aut.); Wolfson Centre for Age-Related Diseases/London/Royaume-Uni (13 aut.); Department of Neurology, Mayo Clinic/Rochester, MN/Etats-Unis (14 aut.); Institute of Nuclear Medicine, HPP Medicina Molecular, SA/Porto/Portugal (16 aut.); Section of Neurology, Hospital Severo Ochoa/Madrid/Espagne (17 aut.); Hopital La Salpêtnère/Paris/France (18 aut.); Dept. of Neuroscience, University of California San Diego/La Jolla/Etats-Unis (19 aut.); MCSA Alzheimer's Disease Research Unit, McGill Centre for Studies in Aging/Quebec/Canada (20 aut.); Department of Neurological Sciences, Rush University Medical Center/Chicago, IL/Etats-Unis (21 aut.); Fundación Jiménez Diaz, Servicio de Neurología/Madrid/Espagne (22 aut.); Prince of Wales Medical Research Institute/Sydney/Australie (23 aut.); Dept. of Pathology, University of California San Diego/La Jolla/Etats-Unis (24 aut.); Laboratory of Neurogenetics, National Institute on Aging/Bethesda, MD/Etats-Unis (25 aut.); Department of Neuropathology & Neuroscience, University of Tokyo/Japon (26 aut.); Dept. of Neurology CB 7025, University of North Carolina School of Medicine/Chapel Hill/Etats-Unis (28 aut.); Department of Neurology, Tel-Aviv University/Israël (30 aut.)</AF><DT>Publication en série; Niveau analytique</DT><SO>Neurology; ISSN 0028-3878; Coden NEURAI; Etats-Unis; Da. 2005; Vol. 65; No. 12; Pp. 1863-1872; Bibl. 105 ref.</SO><LA>Anglais</LA><EA>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 ∼50%, and improvements in attention, visual hallucinations, and sleep disorders with cholinesterase inhibitors.</EA><CC>002B17; 002B17G; 002B17E</CC><FD>Système nerveux pathologie; Diagnostic; Conduite à tenir; Démence corps Lewy</FD><ED>Nervous system diseases; Diagnosis; Clinical management; Lewy body dementia</ED><SD>Sistema nervioso patología; Diagnóstico; Actitud médica; Demencia cuerpos Lewy</SD><LO>INIST-6345.354000134375700040</LO><ID>06-0077698</ID></server></inist></record>Pour manipuler ce document sous Unix (Dilib)
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