Early diagnosis of dementia with Lewy bodies:current status and issues

Hiroshige Fujishiro

Department of Psychiatry, Nagoya University Graduate School of Medicine

Dementia with Lewy bodies (DLB) is the second most common neurodegenerative dementing disorder after Alzheimer's disease (AD). In terms of the administration of disease-modifying therapeutics, DLB has some advantages compared to AD. First, the screening method to identify individuals at high risk of developing dementia needs to be simple and cost-effective. Although only subtle cognitive/behavioral decline may lead us to suspect very early AD, various non-cognitive symptoms, including REM sleep behavior disorder and olfactory dysfunction, are also useful in prodromal DLB. Second, peripheral tissue biopsy can identify phosphorylated alpha-synuclein staining before autopsy confirmation. Considering the long-term nature of DLB, determining the clinical findings that predict the development of cognitive decline is warranted. The long prodromal phase of DLB provides a critical opportunity for potential intervention with disease-modifying therapy, but only if we are able to clearly identify the diversity in the clinical courses of DLB.

Address correspondence to Dr. Hiroshige Fujishiro, Department of Psychiatry, Nagoya University Graduate School of Medicine (65 Tsurumai, Showa, Nagoya, Aichi 466-8550, Japan)

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