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Titolo:
CONSENSUS GUIDELINES FOR THE CLINICAL AND PATHOLOGICAL DIAGNOSIS OF DEMENTIA WITH LEWY BODIES (DLB) - REPORT OF THE CONSORTIUM ON DLB INTERNATIONAL WORKSHOP
Autore:
MCKEITH IG; GALASKO D; KOSAKA K; PERRY EK; DICKSON DW; HANSEN LA; SALMON DP; LOWE J; MIRRA SS; BYRNE EJ; LENNOX G; QUINN NP; EDWARDSON JA; INCE PG; BERGERON C; BURNS A; MILLER BL; LOVESTONE S; COLLERTON D; JANSEN ENH; BALLARD C; DEVOS RAI; WILCOCK GK; JELLINGER KA; PERRY RH;
Indirizzi:
NEWCASTLE GEN HOSP,DEPT OLD AGE PSYCHIAT,INST HLTH ELDERLY,WESTGATE RD NEWCASTLE TYNE NE4 6BE TYNE & WEAR ENGLAND ELI LILLY & CO,LILLY CORP CTR INDIANAPOLIS IN 46285 MRC,NEUROCHEM PATHOL UNIT NEWCASTLE TYNE TYNE & WEAR ENGLAND UNIV TORONTO,RES CTR NEURODEGENERAT DIS TORONTO ON CANADA UNIV MANCHESTER,DEPT PSYCHIAT MANCHESTER LANCS ENGLAND INST PSYCHIAT LONDON ENGLAND BENSHAM GEN HOSP,DEPT CLIN PSYCHOL NEWCASTLE TYNE TYNE & WEAR ENGLAND BAYER PLC LONDON ENGLAND ASTRA NEUROSCI RES UNIT LONDON WC1N 1PJ ENGLAND STREEKLAB PATHOL ENSCHEDE NETHERLANDS ALBERT EINSTEIN COLL MED,DEPT PATHOL NEW YORK NY 00000 INST NEUROL FRANKFURT GERMANY ST CHARLES HOSP LONDON W10 6DZ ENGLAND SANDOZ PHARMA LTD CH-4002 BASEL SWITZERLAND NEWCASTLE CITY HLTH NHS TRUST NEWCASTLE TYNE TYNE & WEAR ENGLAND UNIV CALIF SAN DIEGO,DEPT NEUROSCI SAN DIEGO CA 92103 UNIV CAMBRIDGE,SCH CLIN CAMBRIDGE CB2 1TN ENGLAND MRC LONDON ENGLAND HOSP MED SPECTRUM TWENTE ENSCHEDE NETHERLANDS NEWCASTLE GEN HOSP,DEPT NEUROPATHOL NEWCASTLE TYNE NE4 6BE TYNE & WEAR ENGLAND LUDWIG BOLTZMANN INST CLIN NEUROBIOL VIENNA AUSTRIA TEL AVIV UNIV,DEPT NEUROL IL-69978 TEL AVIV ISRAEL YOKOHAMA CITY UNIV,DEPT PSYCHIAT YOKOHAMA KANAGAWA 232 JAPAN MIE UNIV,SCH MED,DEPT NEUROL TSU MIE 514 JAPAN CTR HOSP REG & UNIV LILLE,CTR MEMOIRE LILLE FRANCE UNIV BRITISH COLUMBIA,VANCOUVER HOSP & HLTH SCI CTR VANCOUVER BC CANADA UNIV NOTTINGHAM,SCH MED,DEPT NEUROL NOTTINGHAM ENGLAND UNIV BRESCIA,DIV PHARMACOL BRESCIA ITALY UNIV NOTTINGHAM,QUEENS MED CTR NOTTINGHAM NG7 2UH ENGLAND UNIV NEWCASTLE UPON TYNE,DEPT PSYCHIAT NEWCASTLE TYNE NE1 7RU TYNE & WEAR ENGLAND COLUMBIA UNIV NEW YORK NY 00000 UNIV OXFORD,DEPT PSYCHIAT OXFORD ENGLAND UNIV CALIF LOS ANGELES,DEPT NEUROL LOS ANGELES CA 90024 VET AFFAIRS MED CTR,DEPT PATHOL & LAB MED ATLANTA GA 30033 EMORY UNIV,SCH MED ATLANTA GA 00000 UNIV LONDON KINGS COLL LONDON WC2R 2LS ENGLAND INST NEUROL LONDON WC1N 3BG ENGLAND UNIV SHEFFIELD,DEPT CLIN NEUROL SHEFFIELD S YORKSHIRE ENGLAND UNIV CALIF SAN DIEGO,ALZHEIMERS DIS RES CTR SAN DIEGO CA 92103 MERCK SHARP & DOHME LTD HARLOW CM20 2QR ESSEX ENGLAND BENSHAM GEN HOSP,DEPT OLD AGE PSYCHIAT NEWCASTLE TYNE TYNE & WEAR ENGLAND MRC,CTR CLIN SCI LONDON ENGLAND WELLCOME TRUST RES LABS LONDON ENGLAND UNIV BRISTOL,DEPT CARE ELDERLY BRISTOL AVON ENGLAND
Titolo Testata:
Neurology
fascicolo: 5, volume: 47, anno: 1996,
pagine: 1113 - 1124
SICI:
0028-3878(1996)47:5<1113:CGFTCA>2.0.ZU;2-P
Fonte:
ISI
Lingua:
ENG
Soggetto:
ALZHEIMERS-DISEASE; BODY DISEASE; SENILE DEMENTIA; PARKINSONS-DISEASE; VARIANT; IMMUNOCYTOCHEMISTRY; FEATURES; CRITERIA;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
49
Recensione:
Indirizzi per estratti:
Citazione:
I.G. Mckeith et al., "CONSENSUS GUIDELINES FOR THE CLINICAL AND PATHOLOGICAL DIAGNOSIS OF DEMENTIA WITH LEWY BODIES (DLB) - REPORT OF THE CONSORTIUM ON DLB INTERNATIONAL WORKSHOP", Neurology, 47(5), 1996, pp. 1113-1124

Abstract

Recent neuropathologic autopsy studies found that 15 to 25% of elderly demented patients have Lewy bodies (LB) in their brainstem and cortex, and in hospital series this may constitute the most common pathologic subgroup after pure Alzheimer's disease (AD). The Consortium on Dementia with Lewy bodies met to establish consensus guidelines for the clinical diagnosis of dementia with Lewy bodies (DLB) and to establish a common framework for the assessment and characterization of pathologic lesions at autopsy. The importance of accurate antemortem diagnosisof DLB includes a characteristic and often rapidly progressive clinical syndrome, a need for particular caution with neuroleptic medication, and the possibility that DLB patients may be particularly responsiveto cholinesterase inhibitors. We identified progressive disabling mental impairment progressing to dementia as the central feature of DLB. Attentional impairments and disproportionate problem solving and visuospatial difficulties are often early and prominent. Fluctuation in cognitive function, persistent well-formed visual hallucinations, and spontaneous motor features of parkinsonism are core features with diagnostic significance in discriminating DLB from AD and other dementias. Appropriate clinical methods for eliciting these key symptoms are described. Brainstem or cortical LB are the only features considered essential for a pathologic diagnosis of DLB, although Lewy-related neurites, Alzheimer pathology, and spongiform change may also be seen. We identified optimal staining methods for each of these and devised a protocolfor the evaluation of cortical LB frequency based on a brain samplingprocedure consistent with CERAD. This allows cases to be classified into brainstem predominant, limbic (transitional), and neocortical subtypes, using a simple scoring system based on the relative distributionof semiquantitative LB counts. Alzheimer pathology is also frequentlypresent in DLB, usually as diffuse or neuritic plaques, neocortical neurofibrillary tangles being much less common. The precise nosologicalrelationship between DLB and AD remains uncertain, as does that between DLB and patients with Parkinson's disease who subsequently develop neuropsychiatric features. Finally, we recommend procedures for the selective sampling and storage of frozen tissue for a variety of neurochemical assays, which together with developments in molecular genetics,should assist future refinements of diagnosis and classification.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 23/09/20 alle ore 13:07:07