Clinical Subtypes of Dementia with Lewy Bodies Based on the Initial Clinical Presentation

Estrella Morenas-Rodríguez, Isabel Sala, Andrea Subirana, Elba Pascual-Goñi, Ma Belén Sánchez-Saudinós, Daniel Alcolea, Ignacio Illán-Gala, María Carmona-Iragui, Roser Ribosa-Nogué, Valle Camacho, Rafael Blesa, Juan Fortea, Alberto Lleó
  • Journal of Alzheimer s Disease, June 2018, IOS Press
  • DOI: 10.3233/jad-180167

Three well-differentiated clinical subtypes within dementia with Lewy bodies

What is it about?

Dementia with Lewy bodies is a disease with a large clinical heterogeneity in which both symptoms and evolution can vary widely among patients. This clinical heterogeneity is linked to the great neuropathological variability found in autopsy. The variety of symptoms and evolution makes difficult the correct diagnosis of the patients and, subsequently, their symptomatic treatment. It also makes difficult the research in the field, aimed to a better understanding of the disease. In our study entitled "Clinical subtypes in dementia with Lewy bodies based on their initial clinical presentation", published in Journal of Alzheimer's Disease, we present for the first time three clinical subtypes based on the initial symptoms of the disease that show different evolutions: a cognitive subtype, with a predominance of cognitive symptoms over the rest of typical features and a slow evolution; a neuropsychiatric subtype, with a marked presence of visual hallucinations and a higher age of onset, and a parkinsonian subtype of rapid evolution with a predominance of motor symptoms from the onset of the disease. This study is also novel by the application of a data driven analysis and the use of a mathematical formula to calculate the predominance of symptoms during the onset of the disease, which avoids biases.

Why is it important?

We are pioneer in the publication of the first study in which clinical subtypes are described within Dementia with Lewy bodies. That will help in the correct classification and diagnosis of the patients affected by this neurodegenerative dementia. A very important point in this study is that it shows the great relevance and improve the knowledge of the different clinical features during the prodromal phase of Dementia with Lewy bodies, a stage for which we do not have yet diagnostic criteria. This better understanding of the disease and its prodromal phase will improve the clinical management and also the general knowledge for patients and their relatives. Besides that, the novelty in the use of a data driven analysis results in a more objective study. This type of analysis, still not very widespread, is beginning to gain popularity today in biomedical research.

Perspectives

Estrella Morenas-Rodríguez (Author)
German Center for Neurodegenerative Diseases (DZNE) - Munich

This study is crucial in the understanding of dementia with Lewy bodies and opens the way to new investigations focused on disentangling the great heterogeneity of this disease. To disentangle this heterogeneity it is also essential to continue making our way in the investigation of causes and processes of dementia with Lewy bodies, always targeting the development of much needed future treatments.

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http://dx.doi.org/10.3233/jad-180167

The following have contributed to this page: Dr Alberto Lleo and Estrella Morenas-Rodríguez