David Holtzman, MD: Difficulties Identifying Dementia With Lewy Bodies

“In Alzheimer disease, it goes down substantially, so you can pretty much tell who has amyloid in the brain or not from just a cerebral spinal fluid test, and now there are blood tests being developed. Unfortunately, with the synucleinopathies, we’re not sure why, but this biochemical change isn’t as robust.”

Although Alzheimer disease is perhaps the most well-known and certainly the most common cause of neurodegeneration in humans, dementia with Lewy Bodies is a close second. Caused by a buildup of α-synuclein, the condition often causes symptoms including Parkinsonism, hallucinations, and cognitive dysfunction.

David M. Holtzman, MD, a professor and the chair of neurology at Washington University in St. Louis, has been working in the research toward addressing these neurodegenerative conditions for years. All too familiar with the challenges in treating these patients, he’s also experienced the difficulty in identifying dementia with Lewy Bodies—one that Alzheimer does not share. While Alzheimer is just as devastating, clinicians are at least able to easily identify the buildup of amyloid. With synucleinopathies such as Lewy Body dementia, that buildup is more difficult to identify.

At the American Neurological Association’s (ANA) 143rd Annual Meeting in Atlanta, Georgia, Holtzman spoke with NeurologyLive about what’s being developed to improve the imaging agents used to observe dementia with Lewy bodies. The current president of the ANA specifically mentioned the work some groups are doing with small molecule imaging methods.