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Diagnosis and management of dementia with Lewy bodies Fourth consensus report of the DLB Consortium

McKeith, IG; Boeve, BF; Dickson, DW; Halliday, G; Taylor, J-P; Weintraub, D; Aarsland, D; ... Kosaka, K; + view all (2017) Diagnosis and management of dementia with Lewy bodies Fourth consensus report of the DLB Consortium. Neurology , 89 (1) pp. 88-100. 10.1212/WNL.0000000000004058. Green open access

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Abstract

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 123iodine-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.

Type: Article
Title: Diagnosis and management of dementia with Lewy bodies Fourth consensus report of the DLB Consortium
Open access status: An open access version is available from UCL Discovery
DOI: 10.1212/WNL.0000000000004058
Publisher version: http://dx.doi.org/10.1212/WNL.0000000000004058
Language: English
Additional information: © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology. This is an open access article distributed under the terms of the Creative Commons Attribution License 4.0 (CC BY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: SLEEP BEHAVIOR DISORDER, AUTOPSY-CONFIRMED DEMENTIA, ALZHEIMERS-DISEASE, PARKINSONS-DISEASE, COGNITIVE IMPAIRMENT, ALPHA-SYNUCLEIN, BODY DEMENTIAS, VISUAL HALLUCINATIONS, CLINICIAN, PSYCHOSIS
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Neurodegenerative Diseases
URI: https://discovery.ucl.ac.uk/id/eprint/1564839
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