Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Denmark.
Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Denmark; Department of Clinical Medicine, Rigshospitalet, University of Copenhagen, Denmark.
Parkinsonism Relat Disord. 2023 Feb;107:105279. doi: 10.1016/j.parkreldis.2023.105279. Epub 2023 Jan 6.
Three presentations of prodromal dementia with Lewy bodies (DLB) have recently been proposed. This study investigates the frequency of symptoms in the prodromal phase of DLB.
Patients diagnosed with DLB between the 1 of February 2017 and 1 of February 2021 were retrospectively identified and matched to a group of patients diagnosed with Alzheimer's disease (AD). Patient case files were reviewed identifying the first symptoms and symptoms in the prodromal phase (cognitive impairment, psychiatric symptoms, delirium/acute confusional episodes, RBD, motor symptoms indicative of Parkinson's disease, anosmia, and autonomic dysfunction).
A total of 166 DLB patient and 168 AD patients were included. Of the proposed presentations in patients diagnosed with DLB, 30% presented with cognitive impairment at onset in isolation, 6% with psychiatric symptoms, and 2% with delirium/acute confusional episodes. Prodromal DLB was more likely to present with no cognitive symptoms at initial presentation (38% vs 10%) and was more likely to involve other symptoms (69% vs 26%). Of other possible presentations, Rapid eye-movement sleep Behaviour Disorder (RBD) was found at onset in 22% with a mean prodromal length of 8.4 years (all symptoms: mean 4.3 years, SD 5.8).
We found some supportive evidence of the proposed cognitive and psychiatric presentations of prodromal DLB. Our findings build on previous findings that an RBD presentation exist, and further research is needed to characterise this presentation.
最近提出了三种前驱期路易体痴呆（DLB）的表现。本研究调查了 DLB 前驱期的症状频率。
回顾性地确定了 2017 年 2 月 1 日至 2021 年 2 月 1 日期间被诊断为 DLB 的患者，并将其与一组被诊断为阿尔茨海默病（AD）的患者进行匹配。审查患者的病例档案，确定首发症状和前驱期症状（认知障碍、精神症状、谵妄/急性意识混乱发作、快速眼动睡眠行为障碍、提示帕金森病的运动症状、嗅觉丧失和自主神经功能障碍）。
共纳入 166 例 DLB 患者和 168 例 AD 患者。在诊断为 DLB 的患者中，有 30%以孤立性认知障碍起病，6%以精神症状起病，2%以谵妄/急性意识混乱发作为起病。前驱期 DLB 更有可能在初次就诊时无认知症状（38%比 10%），并且更有可能涉及其他症状（69%比 26%）。其他可能的表现中，快速眼动睡眠行为障碍（RBD）在发病时出现，占 22%，前驱期平均长度为 8.4 年（所有症状：平均 4.3 年，SD 5.8）。
我们发现了一些支持前驱期 DLB 认知和精神表现的证据。我们的发现建立在前瞻性研究表明 RBD 表现存在的基础上，需要进一步研究来描述这种表现。
