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[路易体痴呆:新旧知识 - 第1部分:临床方面与诊断]

[Dementia with Lewy bodies: old and new knowledge - Part 1: clinical aspects and diagnostics].

作者信息

Dodel Richard, Berg Daniela, Duning Thomas, Kalbe Elke, Meyer Philipp T, Ramirez Alfredo, Storch Alexander, Aarsland Dag, Jessen Frank

机构信息

Lehrstuhl für Geriatrie, Universität Duisburg-Essen, Virchowstraße 171, 45147, Essen, Deutschland.

Neurologische Klinik, Universität Kiel, Kiel, Deutschland.

出版信息

Nervenarzt. 2024 Apr;95(4):353-361. doi: 10.1007/s00115-023-01576-3. Epub 2023 Dec 13.

Abstract

BACKGROUND

Dementia with Lewy bodies (DLB) is the second most common neurodegenerative dementia after Alzheimer's disease. Patients with DLB often have a poor prognosis, with worse outcomes than patients with Alzheimer's disease in terms of important parameters, such as quality of life, caregiver burden, health-related costs, frequency of hospital and nursing home admissions, shorter time to severe dementia, and lower survival. The DLB is frequently misdiagnosed and often undertreated. Therefore, it is critical to diagnose DLB as early as possible to ensure optimal care and treatment.

OBJECTIVE

The aim of this review article is to summarize the main recent findings on diagnostic tools, epidemiology and genetics of DLB.

RESULTS

Precise clinical diagnostic criteria exist for DLB that enable an etiologic assignment. Imaging techniques are used as standard in DLB, especially also to exclude non-neurodegenerative causes. In particular, procedures in nuclear medicine have a high diagnostic value.

DISCUSSION

The diagnosis is primarily based on clinical symptoms, although the development of in vivo neuroimaging and biomarkers is changing the scope of clinical diagnosis as well as research into this devastating disease.

摘要

背景

路易体痴呆(DLB)是仅次于阿尔茨海默病的第二常见神经退行性痴呆。DLB患者的预后通常较差,在生活质量、照顾者负担、医疗相关费用、住院和入住养老院频率、发展为重度痴呆的时间较短以及生存率较低等重要参数方面,其结果比阿尔茨海默病患者更差。DLB经常被误诊,且治疗往往不足。因此,尽早诊断DLB以确保最佳护理和治疗至关重要。

目的

这篇综述文章的目的是总结DLB诊断工具、流行病学和遗传学方面的近期主要研究结果。

结果

DLB存在精确的临床诊断标准,可进行病因诊断。成像技术在DLB中作为标准使用,特别是用于排除非神经退行性病因。尤其是核医学检查具有很高的诊断价值。

讨论

诊断主要基于临床症状,尽管体内神经成像和生物标志物的发展正在改变临床诊断的范围以及对这种毁灭性疾病的研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c92/11014876/ee635381e1a6/115_2023_1576_Fig1_HTML.jpg

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