Kimura Naohiro, Chadani Yoshihiro, Kawai Ryo, Fujito Ryoko, Kanemoto Hideki, Takahashi Ryuichi, Kashibayashi Tetsuo, Shinagawa Shunichiro, Tagai Kenji, Ishii Kazunari, Ikeda Manabu, Kazui Hiroaki
Department of Neuropsychiatry, Kochi Medical School, Kochi University, Nankoku, Japan.
Department of Rehabilitation, Atago Hospital Branch, Kochi, Japan.
Int J Geriatr Psychiatry. 2025 Sep;40(9):e70150. doi: 10.1002/gps.70150.
The association between core clinical features and anxiety and the neural basis of anxiety in patients with dementia with Lewy bodies (DLB) are unknown. Therefore, this study examined the core clinical features associated with anxiety in DLB and identified the brain regions associated with anxiety using statistical imaging analysis.
This study was conducted using a part of the data from "The Japan multicenter study: Behavioral and psychological symptoms Integrated Research in Dementia-Retrospective Neuroimaging part". Overall, 40 patients with probable DLB whose clinical dementia rating score was either 0.5 or 1 were included in this study. Anxiety was evaluated using the Neuropsychiatric Inventory (NPI). The incidence of each of the 4 core features was compared between patients with and without anxiety, and the brain regions associated with anxiety were examined using single-photon emission computed tomography data.
Patients with DLB with anxiety had a significantly higher percentage of fluctuating cognition than those without anxiety. The NPI anxiety score was significantly negatively correlated with regional cerebral blood flow in the right supramarginal gyrus in patients with DLB.
Anxiety in DLB is associated with fluctuating cognition. It is also likely that the brain regions associated with anxiety in DLB are potentially influenced by the neurofunctional characteristics of DLB, in which the parietal lobes are more likely to be impaired.
路易体痴呆（DLB）患者的核心临床特征与焦虑之间的关联以及焦虑的神经基础尚不清楚。因此，本研究调查了DLB中与焦虑相关的核心临床特征，并使用统计成像分析确定了与焦虑相关的脑区。
本研究使用了“日本多中心研究：痴呆行为和心理症状综合研究-回顾性神经影像学部分”的部分数据。总体而言，本研究纳入了40例临床痴呆评定量表评分为0.5或1的可能患有DLB的患者。使用神经精神科问卷（NPI）评估焦虑。比较有焦虑和无焦虑患者中4种核心特征各自的发生率，并使用单光子发射计算机断层扫描数据检查与焦虑相关的脑区。
伴有焦虑的DLB患者认知波动的比例明显高于无焦虑的患者。DLB患者的NPI焦虑评分与右侧缘上回的局部脑血流量显著负相关。
DLB中的焦虑与认知波动有关。DLB中与焦虑相关的脑区也可能受到DLB神经功能特征的影响，其中顶叶更易受损。
