Commentary
Video
Potential of Newer Techniques to Diagnose Dementia with Lewy Bodies: James Leverenz, MD
The director of the Cleveland Lou Ruvo Center for Brain Health at Cleveland Clinic talked about challenges of accurately diagnosing dementia with Lewy bodies as well as new methods that show promise in guiding treatment. [WATCH TIME: 3 minutes]
WATCH TIME: 3 minutes
"We're recognizing that we're often not diagnosing [dementia with Lewy bodies] correctly, that we're finding out later that either people had it and we didn't know it, or vice versa."
Although Synuclein Aggregate Assays (SAA) in cerebrospinal fluid (CSF) and in skin biopsy have shown success in identifying underlying synuclein (Lewy body) pathology in Parkinson disease, there is limited data among those with Lewy body dementia (LBD). Using data from the U.S. based Dementia with Lewy Bodies Consortium (DLBC), a recent study showed that CSF-based SAA testing performed well in LBD with autopsy-confirmed limbic or neocortical stage Lewy body pathology (LBP).1
In the study, investigators explored the performance of CSF-based SAA and AD biomarkers during life to post-mortem presence and staging of LBP and Alzheimer's disease Neuropathologic Change (ADNC) of the participants from DLBC. Currently, the DLBC enrolled 31 of these cases that came to autopsy and were staged for LBP, ADNC, and TDP-43 pathology. Additionally results of this analysis revealed that detection of LBP was less reliable when in more limited anatomic locations, brainstem or amygdala and had no observations of false positive CSF SAA in this sample of LBD.
These findings were presented at the 2024 Alzheimer’s Association International Conference, July 28 to August 1, in Philadelphia, Pennsylvania, by James Leverenz, MD, director of the Cleveland Lou Ruvo Center for Brain Health at Cleveland Clinic. At the conference, Leverenz sat down with NeurologyLive® in an interview to discuss the challenges currently faced in accurately diagnosing patients with LBD in the clinical setting. He also talked about how the newer technique involving spinal fluid markers can potentially improve diagnostic accuracy for these patients. Furthermore, Leverenz spoke about the implications of misdiagnosing LBD for treatment and drug development.
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REFERENCES
1. Leverenz JB, Patel P, Bekris LM, et al. Synuclein Aggregate Assay Performance in Autopsy-Confirmed Lewy Body Dementia: Results from the U.S. Dementia with Lewy Bodies Consortium. Presented at: 2024 Alzheimer’s Association International Conference; July 18 to August 1; Philadelphia, Pennsylvania.
