James Leverenz, MD: Differentiating Lewy Body Dementia

“The clinical syndrome, particularly as laid out by the DLB Consortium, is pretty accurate in identifying individuals who are likely to have Lewy body pathology at autopsy. What we’re finding, though, is that a lot of people, especially those who have Alzheimer and Lewy bodies together, frequently do not fulfill the full clinical diagnostic criteria.”

According to data from the National Institutes of Health (NIH), Lewy body dementia accounts for an estimated 3.2% to 7.1% of all dementia cases, with some prevalence studies estimating as high as 24%. Despite this, its diagnosis remains challenging, with no available biomarker specific to its pathology and its symptoms often causing it to be confused for Alzheimer disease or Parkinson disease.^1,2

To combat this challenge, the NIH has funded a number of studies to attempt to identify a method of differentiating patients with Lewy body dementia from other dementias. James Leverenz, MD, director, Cleveland Lou Ruvo Center for Brain Health, Cleveland Clinic, is one physician included in this research, who is looking specifically into a number of imaging tactics to attempt to stratify these individuals.

In a conversation with NeurologyLive, Leverenz laid out these challenges that he and his colleagues face in diagnosing these patients and further explained some of the work being done to tackle these issues. He also shared his insight into what has been found thus far and if there is promise in any particular route of study to this point.

REFERENCES

1. Hogan DB, Fiest KM, Roberts JI, et al. The Prevalence and Incidence of Dementia with Lewy Bodies: a Systematic Review. Can J Neurol Sci. 2016;43 Suppl 1:S83-95. doi: 10.1017/cjn.2016.2.

2. NIH. What Is Lewy Body Dementia? NIH website. nia.nih.gov/health/what-lewy-body-dementia. Reviewed June 27, 2018. Accessed October 23, 2019.