Planas-Ballvé Anna, Rios José, Ispierto Lourdes, Gea Mireia, Grau Laia, Jiménez Marta, Cáceres Cynthia, Martínez Sílvia, Beyer Katrin, Álvarez Ramiro, Pastor Pau, Vilas Dolores
Movement Disorders Unit, Neurology Department, Complex Hospitalari Moisès Broggi, Barcelona, Spain.
Movement Disorders Unit, Neurology Department, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain.
Front Neurol. 2025 Mar 13;16:1555175. doi: 10.3389/fneur.2025.1555175. eCollection 2025.
The objective of our study was to characterize early-stage dementia with Lewy bodies (DLB) focusing on motor and non-motor symptoms.
This cross-sectional study prospectively included newly diagnosed DLB patients within 3 years of cognitive symptom onset. Comparisons were made with individuals with Parkinson's disease (PD), Alzheimer's disease (AD), and controls. Demographic and clinical data were collected, and motor and non-motor symptoms were assessed using structured interviews and validated scales and questionnaires.
A total of 107 participants were included (23 DLB, 27 PD, 26 AD, and 31 controls). DLB patients (median age 75 years, median disease duration since diagnosis 2 months) commonly reported motor symptoms, including gait disturbances (91.3%), tremor (73.9%), and bradykinesia (87%), with tremor being predominantly unilateral (76.5%) and action-type (52.9%). The most frequent motor subtype was akinetic-rigid (52.2%). Motor symptoms were similar to PD, except for more frequent falls (34.8% vs. 11.1%, = 0.044) and gait disturbances in DLB patients (91.3% vs. 63%, = 0.019). Non-motor symptoms, particularly visual hallucinations and neuropsychiatric symptoms were more prevalent in DLB than in PD, while sleep and autonomic symptoms were similar. An abnormal orthostatic test was more frequent in DLB than in PD (45.5% vs. 11.5%, < 0.008). Compared to AD, all non-motor symptoms were significantly more frequent in DLB. Finally, DLB patients had lower functional independence and quality of life than both PD and AD ( < 0.0001).
Early-stage DLB closely resembles PD in motor symptoms but has more neuropsychiatric non-motor symptoms compared to PD and overall non-motor symptoms than AD.
我们研究的目的是对早期路易体痴呆（DLB）进行特征描述，重点关注运动和非运动症状。
这项横断面研究前瞻性纳入了认知症状出现3年内新诊断的DLB患者。与帕金森病（PD）、阿尔茨海默病（AD）患者及对照组进行比较。收集人口统计学和临床数据，并使用结构化访谈以及经过验证的量表和问卷对运动和非运动症状进行评估。
共纳入107名参与者（23例DLB、27例PD、26例AD和31名对照）。DLB患者（中位年龄75岁，自诊断起疾病持续时间中位数为2个月）普遍报告有运动症状，包括步态障碍（91.3%）、震颤（73.9%）和运动迟缓（87%），震颤主要为单侧（76.5%）且为动作性震颤（52.9%）。最常见的运动亚型是运动不能 - 强直型（52.2%）。运动症状与PD相似，但DLB患者跌倒更频繁（34.8%对11.1%，P = 0.044）以及步态障碍更常见（91.3%对63%，P = 0.019）。非运动症状，尤其是视幻觉和神经精神症状在DLB中比在PD中更普遍，而睡眠和自主神经症状相似。DLB患者直立试验异常比PD更常见（45.5%对11.5%，P < 0.008）。与AD相比，DLB中所有非运动症状都明显更常见。最后，DLB患者的功能独立性和生活质量低于PD和AD（P < 0.0001）。
早期DLB在运动症状上与PD非常相似，但与PD相比有更多神经精神非运动症状，与AD相比总体非运动症状更多。
