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| Research article summary (published 30 Dec 2001): |
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Research evaluation and prospective diagnosis of dementia with Lewy bodies.
Full Abstract
OBJECTIVE:
To evaluate the relative merits of recently developed criteria for dementia with Lewy bodies (DLBs) in a longitudinal study of dementia.
DESIGN:
The diagnosis of DLBs was used in combination with other clinical diagnosis. Patients were classified primarily based on the NINCDS-ADRDA (National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association) clinical criteria for probable or possible Alzheimer disease, or with other disease process that can cause dementia (eg, Parkinson disease), and secondarily according to the consensus guidelines for DLBs. This "double" clinical diagnosis was implemented to capture different pathological entities. The neuropathological diagnosis of Lewy bodies was made with monoclonal antibodies against alpha-synuclein.
SETTING:
Multidisciplinary research clinic.
RESULTS:
Prospective application of the consensus guidelines for DLBs from January 1, 1997, to September 29, 2000, identified 11 patients having the diagnosis of probable DLBs and 35 having possible DLBs. The diagnosis of probable or possible DLBs was associated with probable Alzheimer disease in 34 patients, with possible Alzheimer disease in 5 patients, with Parkinson disease in 2 patients, and with other disease processes in 2 patients. Three patients were diagnosed as having probable DLBs alone. An autopsy was performed in 26 of the cases who were clinically examined during the study period. Cortical Lewy bodies were identified in 13 cases; 4 had had premortem diagnosis of DLBs (sensitivity, 30.7%; specificity, 100%).
CONCLUSIONS:
The prospective validation of the clinical criteria for DLBs showed poor accuracy in this series. We believe that current criteria for DLBs are useful when DLBs occur in isolation, but have low sensitivity when Lewy bodies coexist with the pathological abnormalities of Alzheimer disease.
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Author information
Author/s: Lopez, Oscar L (OL); Becker, James T (JT); Kaufer, Daniel I (DI); Hamilton, Ronald L (RL); Sweet, Robert A (RA); Klunk, William (W); DeKosky, Steven T (ST);
Affiliation: Alzheimer's Disease Research Center, University of Pittsburgh, Pa, USA.
Grants: AG05133 (Agency:United States NIA) ; KO2-MH01077 (Agency:United States NIMH)
Journal and publication information
Publication Type: Clinical Trial; Journal Article; Research Support, U.S. Gov't, P.H.S.
Journal: Archives of neurology (Arch Neurol), published in United States. (Language: eng)
Reference: 2002-Jan; vol 59 (issue 1) : pp 43-6
Dates: Created 2002/01/15; Completed 2002/01/31; Revised 2007/11/14;
PMID: 11790229, status: MEDLINE (last retrieval date: 11/6/2008)
Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.
Comments and Corrections
CommentIn: Arch Neurol. 2002 Jan;59(1):29-30. (PMID: 11790227)
CommentIn: Arch Neurol. 2003 Mar;60(3):452. (PMID: 12633161)
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