Park Mincheol, Baik Kyoungwon, Sohn Young H, Ye Byoung Seok
Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
Department of Neurology, Chung-Ang University College of Medicine and Graduate School of Medicine, Gwangmyeong Hospital, Gwangmyeong, Korea.
Dement Neurocogn Disord. 2024 Jan;23(1):11-21. doi: 10.12779/dnd.2024.23.1.11. Epub 2024 Feb 5.
Although dementia with Lewy bodies (DLB) is the second most common cause of neurodegenerative dementia, its clinical prevalence is low. We developed a short and easy-to-complete DLB screening questionnaire (DLBSQ) to raise diagnostic sensitivity in routine clinical settings.
A total of 501 participants were retrospectively enrolled, including 71 controls, 184 patients without DLB, and 246 patients with probable DLB. All patients underwent clinical evaluation, including core features of DLB, the DLBSQ, brain magnetic resonance imaging, and detailed neuropsychological assessments. The diagnostic performance of the DLBSQ for probable DLB was investigated using a receiver operating characteristic curve analysis.
Total DLBSQ score was associated with visuospatial and frontal/executive dysfunction and the diagnosis of probable DLB. The area under the receiver operating characteristic curve for total DLBSQ score was 0.727. Youden's method revealed an optimal cutoff value of 3. The sensitivity and specificity of the DLBSQ were 68.7% and 62.4%, respectively. Its discriminating performance improved when cognitive test profiles were additionally considered (area under the curve: 0.822, sensitivity: 80.6%, and specificity: 70.4%).
The DLBSQ might be a useful screening tool for DLB in routine clinical practice with good sensitivity and specificity.
虽然路易体痴呆(DLB)是神经退行性痴呆的第二大常见病因,但其临床患病率较低。我们开发了一种简短且易于完成的DLB筛查问卷(DLBSQ),以提高常规临床环境中的诊断敏感性。
回顾性纳入501名参与者,包括71名对照者、184名无DLB的患者和246名可能患有DLB的患者。所有患者均接受了临床评估,包括DLB的核心特征、DLBSQ、脑磁共振成像和详细的神经心理学评估。使用受试者工作特征曲线分析研究DLBSQ对可能患有DLB的诊断性能。
DLBSQ总分与视觉空间和额叶/执行功能障碍以及可能患有DLB的诊断相关。DLBSQ总分的受试者工作特征曲线下面积为0.727。约登法得出的最佳截断值为3。DLBSQ的敏感性和特异性分别为68.7%和62.4%。当额外考虑认知测试结果时,其鉴别性能有所提高(曲线下面积:0.822,敏感性:80.6%,特异性:70.4%)。
DLBSQ可能是常规临床实践中用于DLB的一种有用的筛查工具,具有良好的敏感性和特异性。