Diagnosis and management of dementia with Lewy bodies

Ian G. McKeith, Bradley F. Boeve, Bradley F. Boeve, Dennis W. DIckson, Glenda Halliday, John Paul Taylor, Daniel Weintraub, Dag Aarsland, Dag Aarsland, James Galvin, Johannes Attems, Johannes Attems, Johannes Attems, Clive G. Ballard, Clive G. Ballard, Ashley Bayston, Ashley Bayston, Thomas G. Beach, Thomas G. Beach, Thomas G. BeachFrédéric Blanc, Nicolaas Bohnen, Nicolaas Bohnen, Nicolaas Bohnen, Laura Bonanni, Laura Bonanni, Jose Bras, Jose Bras, Patrik Brundin, Patrik Brundin, Patrik Brundin, David Burn, David Burn, David Burn, Alice Chen-Plotkin, John E. Duda, Omar El-Agnaf, Howard Feldman, Tanis J. Ferman, Dominic Ffytche, Hiroshige Fujishiro, Douglas Galasko, Jennifer G. Goldman, Jennifer G. Goldman, Jennifer G. Goldman, Stephen N. Gomperts, Stephen N. Gomperts, Stephen N. Gomperts, Neill R. Graff-Radford, Lawrence S. Honig, Lawrence S. Honig, Alex Iranzo, Alex Iranzo, Alex Iranzo, Kejal Kantarci, Daniel Kaufer, Walter Kukull, Virginia M.Y. Lee, James B. Leverenz, James B. Leverenz, Simon Lewis, Carol Lippa, Carol Lippa, Angela Lunde, Mario Masellis, Mario Masellis, Mario Masellis, Eliezer Masliah, Eliezer Masliah, Eliezer Masliah, Eliezer Masliah, Pamela McLean, Pamela McLean, Brit Mollenhauer, Brit Mollenhauer, Brit Mollenhauer, Thomas J. Montine, Thomas J. Montine, Thomas J. Montine, Emilio Moreno, Emilio Moreno, Emilio Moreno, Etsuro Mori, Etsuro Mori, Etsuro Mori, Melissa Murray, Melissa Murray, John T. O'Brien, John T. O'Brien, Sotoshi Orimo, Sotoshi Orimo, Ronald B. Postuma, Ronald B. Postuma, Shankar Ramaswamy, Shankar Ramaswamy, Owen A. Ross, Owen A. Ross, David P. Salmon, David P. Salmon, David P. Salmon

Research output: Contribution to journalReview articlepeer-review

Abstract

© 2017 The Author(s). 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.
Original languageEnglish
Pages (from-to)88-100
Number of pages13
JournalNeurology
Volume89
Issue number1
DOIs
Publication statusPublished - Jul 4 2017
Externally publishedYes

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