Diagnosis and management of dementia with Lewy bodies: Fourth consensus report of the DLB Consortium.
СтатьяОбзорConsensus StatementНазвание и аннотация: Перевод пока не подготовлен
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McKeith Ian G, Boeve Bradley F, Dickson Dennis W, Halliday Glenda, Taylor John-Paul, Weintraub Daniel, Aarsland Dag, Galvin James, Attems Johannes, Ballard Clive G, Bayston Ashley, Beach Thomas G, Blanc Frédéric, Bohnen Nicolaas, Bonanni Laura, Bras Jose, Brundin Patrik, Burn David, Chen-Plotkin Alice, Duda John E, El-Agnaf Omar, Feldman Howard, Ferman Tanis J, Ffytche Dominic, Fujishiro Hiroshige, Galasko Douglas, Goldman Jennifer G, Gomperts Stephen N, Graff-Radford Neill R, Honig Lawrence S, Iranzo Alex, Kantarci Kejal, Kaufer Daniel, Kukull Walter, Lee Virginia M Y, Leverenz James B, Lewis Simon, Lippa Carol, Lunde Angela, Masellis Mario, Masliah Eliezer, McLean Pamela, Mollenhauer Brit, Montine Thomas J, Moreno Emilio, Mori Etsuro, Murray Melissa, O'Brien John T, Orimo Sotoshi, Postuma Ronald B, Ramaswamy Shankar, Ross Owen A, Salmon David P, Singleton Andrew, Taylor Angela, Thomas Alan, Tiraboschi Pietro, Toledo Jon B, Trojanowski John Q, Tsuang Debby, Walker Zuzana, Yamada Masahito, Kosaka Kenji
Аннотация
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.