Objective: To examine the neuropsychological profile of dementia patients fro m a community- based autopsy sample of dementia, comparing Alzheimer disease (A D), Lewy body pathology (LBP) alone, and LBP with coexisten...Objective: To examine the neuropsychological profile of dementia patients fro m a community- based autopsy sample of dementia, comparing Alzheimer disease (A D), Lewy body pathology (LBP) alone, and LBP with coexistent AD (AD/LBP). Methods: The authors reviewed 135 subjects from a community- based study of dementia for wh om autopsy and brain tissue was available. Diagnostic groups were determined acc ording to standard neuropathologic methods and criteria, and the presence of LBs was determined using α - synuclein immunostaining. Neuropathologically define d diagnostic groups of AD, AD/LBP, and LBP were examined for differences on neur opsychological test performance at the time of initial study enrollment. Results : There were 48 patients with AD alone, 65 with LB and AD pathology (AD/LBP), an d 22 with LBP alone (LBP alone). There were no significant differences between g roups demographically or on performance of enrollment Mini- Mental State Examin ation (MMSE) or Dementia Rating Scale (DRS). AD patients performed worse than th e LBP patients on memory measures (Fuld Object Memory Evaluation Delayed Recall, Wechsler Memory Scale Logical Memory Immediate and Delayed Recall; p < 0.05) an d a naming task (Consortium to Establish a Registry for Alzheimer’ s Disease Na ming; p < 0.05). LBP patients were more impaired than AD patients on executive f unction (Trail Making Test Part B; p < 0.05) and attention tasks (Wechsler Adult Intelligence Scale- Revised Digit Span; p < 0.05). Decline in MMSE and DRS sco res over time were greatest in the patients with AD/LBP. Conclusions: In a commu nity- based sample of older, medically complicated patients with dementia, ther e are neuropsychological differences between dementia subtypes at the time of di agnosis. In particular, patients with Alzheimer disease (AD) alone and AD/Lewy b ody pathology (LBP) had more severe memory impairment than patients with LBP. LB P alone was associated with more severe executive dysfunction. Patients with AD/ LBP had the most rapid rate of cognitive decline.展开更多
Background: Iodine- 123- labeled metaiodobenzylguanidine ( 123I- MIBG) myocardial scintigraphy has been used to evaluate cardiac sympathetic denervation in Lewy body disease (LBD) including Parkinson’s disease (PD) a...Background: Iodine- 123- labeled metaiodobenzylguanidine ( 123I- MIBG) myocardial scintigraphy has been used to evaluate cardiac sympathetic denervation in Lewy body disease (LBD) including Parkinson’s disease (PD) and dementia with Lewy bodies (DLB). Patients with LBD had marked reductions in cardiac MIBG accumulation, indicative of severe impairment of the cardiac sympathetic nervous systems. However, the differences in scintigraphy between DLB and PD have not been determined. Objective: To compare cardiac sympathetic function in early disease stage measured with 123I- MIBG scintigraphy between DLB and PD. Methods: 123I- MIBG myocardial scintigraphy was performed in 22 patients with early-stage DLB, 41 patients with early idiopathic PD and 15 normal control subjects who were matched for age and disease duration. The heart-to-mediastinum (H/M) ratio was calculated. Results: 123I- MIBG uptake of the myocardium was significantly lower in patients with early DLB than in controls. The mean value of H/M ratio in patients with DLB was significantly lower than those in patients with PD, independent of the Hoehn and Yahr stage. Conclusions: Our findings suggest that cardiac sympathetic function in DLB is severely impaired even in the early disease stage.展开更多
文摘Objective: To examine the neuropsychological profile of dementia patients fro m a community- based autopsy sample of dementia, comparing Alzheimer disease (A D), Lewy body pathology (LBP) alone, and LBP with coexistent AD (AD/LBP). Methods: The authors reviewed 135 subjects from a community- based study of dementia for wh om autopsy and brain tissue was available. Diagnostic groups were determined acc ording to standard neuropathologic methods and criteria, and the presence of LBs was determined using α - synuclein immunostaining. Neuropathologically define d diagnostic groups of AD, AD/LBP, and LBP were examined for differences on neur opsychological test performance at the time of initial study enrollment. Results : There were 48 patients with AD alone, 65 with LB and AD pathology (AD/LBP), an d 22 with LBP alone (LBP alone). There were no significant differences between g roups demographically or on performance of enrollment Mini- Mental State Examin ation (MMSE) or Dementia Rating Scale (DRS). AD patients performed worse than th e LBP patients on memory measures (Fuld Object Memory Evaluation Delayed Recall, Wechsler Memory Scale Logical Memory Immediate and Delayed Recall; p < 0.05) an d a naming task (Consortium to Establish a Registry for Alzheimer’ s Disease Na ming; p < 0.05). LBP patients were more impaired than AD patients on executive f unction (Trail Making Test Part B; p < 0.05) and attention tasks (Wechsler Adult Intelligence Scale- Revised Digit Span; p < 0.05). Decline in MMSE and DRS sco res over time were greatest in the patients with AD/LBP. Conclusions: In a commu nity- based sample of older, medically complicated patients with dementia, ther e are neuropsychological differences between dementia subtypes at the time of di agnosis. In particular, patients with Alzheimer disease (AD) alone and AD/Lewy b ody pathology (LBP) had more severe memory impairment than patients with LBP. LB P alone was associated with more severe executive dysfunction. Patients with AD/ LBP had the most rapid rate of cognitive decline.
文摘Background: Iodine- 123- labeled metaiodobenzylguanidine ( 123I- MIBG) myocardial scintigraphy has been used to evaluate cardiac sympathetic denervation in Lewy body disease (LBD) including Parkinson’s disease (PD) and dementia with Lewy bodies (DLB). Patients with LBD had marked reductions in cardiac MIBG accumulation, indicative of severe impairment of the cardiac sympathetic nervous systems. However, the differences in scintigraphy between DLB and PD have not been determined. Objective: To compare cardiac sympathetic function in early disease stage measured with 123I- MIBG scintigraphy between DLB and PD. Methods: 123I- MIBG myocardial scintigraphy was performed in 22 patients with early-stage DLB, 41 patients with early idiopathic PD and 15 normal control subjects who were matched for age and disease duration. The heart-to-mediastinum (H/M) ratio was calculated. Results: 123I- MIBG uptake of the myocardium was significantly lower in patients with early DLB than in controls. The mean value of H/M ratio in patients with DLB was significantly lower than those in patients with PD, independent of the Hoehn and Yahr stage. Conclusions: Our findings suggest that cardiac sympathetic function in DLB is severely impaired even in the early disease stage.
