Neurobehavioral features of dementia with Lewy bodies
What are the neurobehavioral characteristics of dementia with Lewy bodies (DLB)?
Dementia with Lewy bodies (DLB) is the second most common progressive neurodegenerative dementia.
The clinical findings can be much more variable than are those in AD. The core feature of DLB is a dementia with a predominant dysexecutive syndrome (frontal lobe involvement).
Memory impairment is usually milder than it is in AD.
Associated features are fluctuations in cognition, early visual hallucinations, and parkinsonian features. Unlike other dementias, visual hallucinations are usually early and recurrent, complex and well formed, and often consist of people and animals.
Sensitivity to neuroleptic medications and rapid eye movement sleep behavior disorder are supportive of the diagnosis.
DLB can be associated with occipital lobe hypometabolism on PET scan, usually in conjunction with frontal and basal ganglia changes, which can help to distinguish it from AD.
Microscopically, it is associated with aggregates of alpha-synuclein called Lewy bodies in cortical, subcortical, and limbic regions.
DLB is also often accompanied by AD pathology and symptoms.
