Clinical symptomatology and pathophysiology of dementia with Lewy bodies

Yasuhiro Nagahama

Department of Geriatric Neurology, Shiga Medical Center

Characteristics of clinical symptoms in dementia with Lewy bodies (DLB) and their pathophysiological mechanisms are discussed.DLB tends to exhibit greater visuoperceptual, attentional and executive impairment and less pronounced memory impairment than Alzheimer disease. The clock drawing impairment in DLB is closely related to dysfunction of the frontal-subcortical network, supporting the concept that DLB is a cortical-subcortical dementia. Neurological symptoms are characterized with symmetrical parkinsonism, less tremor, frequent fall, REM sleep behavior disorder, vertical oculomotor impairment, and dysautonomia. Psychiatric symptoms in DLB are classified into hallucinations, misidentifications, and delusions. These psychiatric symptoms are related to dysfunction of the different brain regions.

Address correspondence to Dr. Yasuhiro Nagahama, Department of Geriatric Neurology, Shiga Medical Center (5-4-30 Moriyama, Moriyama-city, Shiga 524-8524, Japan)