Levodopa response in dementia with lewy bodies: A 1-year follow-up study

Lucetti, Claudio; Logi, Chiara; Dotto, Paolo Del; Berti, Caterina; Ceravolo, Roberto; Baldacci, Filippo; Dolciotti, Cristina; Gambaccini, G; Rossi, Giuseppe; Bonuccelli, Ubaldo

doi:10.1016/j.parkreldis.2010.06.004

Cited by 48 publications

(41 citation statements)

References 20 publications

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“…However, the risk of psychosis exacerbation is lower. Although the effectiveness of L-dopa for DLB is lower than PD, it may be beneficial to the motor symptoms in the long run [42,45]. 2 patients who are treated with selegiline have been reported an improvement in extrapyramidal symptoms, which suggest that monoamine oxidase B (MAOB) may have applied value in DLB therapy.…”

Section: Discussionmentioning

confidence: 99%

Clinical features of dementia with lewy bodies in 35 Chinese patients

Han

Wang

Gao

et al. 2014

Transl Neurodegener

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ObjectiveTo investigate the clinical features of dementia with Lewy bodies (DLB) in a Chinese population.MethodsComputer-based online searches through China Biology Medicine disc and China National Knowledge Infrastructure were performed to collect case reports of DLB published between 1980 and 2012. Clinical characteristics were analyzed.ResultsA total of 18 studies comprising 35 patients (26 males and 9 females) were included. The mean age at onset was 67.2 ± 9.8 years. Onset was characterized by memory impairment and accounted for 58.8% of all cases, followed by parkinsonism (11.8%), visual hallucinations (8.8%), and compulsive personality disorder (2.9%). The other patients (17.6%) presented two of the three core features of DLB at onset. With disease progression, parkinsonism was reported in 100% of cases, followed by visual hallucinations (97.1%), psychiatric symptoms (85.7%), severe neuroleptic sensitivity (81.8%), fluctuating cognition (68.6%), repeated falls (40.0%), sleep disorders (22.9%), and transient loss of consciousness (17.1%). 26 patients who were subjected to Mini-Mental State Examination scored ≤ 24. 10 patients presented relative preservation of hippocampus and medial temporal lobe structures on CT/MRI scan. Occipital hypometabolism occurred in 2 of 3 patients who underwent SPECT/PET perfusion scan. 12 patients showed an increasing of slow frequency activity on EEG, prominently in frontal and temporal lobes.ConclusionsDLB often strikes elderly individuals. Its clinical core features are dementia, fluctuating cognition, recurrent visual hallucinations and spontaneous features of parkinsonism. Neuropsychological, neuroimaging and EEG examinations may improve the diagnostic accuracy and discriminate DLB from other dementias.

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Section: Discussionmentioning

confidence: 99%

Clinical features of dementia with lewy bodies in 35 Chinese patients

Han

Wang

Gao

et al. 2014

Transl Neurodegener

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“…However some dementia with Lewy bodies patients might benefit of L-dopa in terms of motor and cognitive dysfunction and a trial with low-dose of L-dopa could be considered in these patients. 12,13 A comprehensive geriatric assessment should therefore be performed, in order to exclude moderate or severe dementia and to accurately identify possible risks and benefits of dopaminergic treatment.…”

Section: Short Communicationmentioning

confidence: 99%

The key points for treatment of Parkinsonism in older persons

Lauretani¹,

Ticinesi²,

Meschi³

et al. 2017

Geriatr Care

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Signs and symptoms of Parkinsonism have a high prevalence in older persons. Parkinsonism is associated with negative outcomes in the elderly and there is still uncertainty about when and how to start levodopa in these conditions. The diagnosis of idiopathic Parkinson disease is often not pursued in the oldest old.The coexistence of both motor and cognitive impairment is the strongest factor limiting the initiation of treatment with levodopa and/or dopamine agonists in a geriatric setting, given the possibility of producing psychotic symptoms, such as visual hallucinations.It seems reasonable to perform at least one attempt to administer levodopa in older persons with parkinsonism, especially when symptoms and motility disorders are evident, in order to try to obtain an improvement in walking speed and balance. Important signs that should guide treatment for Parkinsonism in older persons are the presence of line-pipe rigidity and cogwheel rigidity.

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“…Levodopa, the main drug of choice for the motor treatment in patients with PD, has been found to be not as effective in patients with DLB as in PD. [62][63][64][65] This drug has also been reported to cause psychosis as a significant side effect in patients with DLB. 63,64 If the motor syndrome is tolerable in patients with DLB, the treatment with Levodopa should be avoided.…”

Section: Motormentioning

confidence: 99%

“…[62][63][64][65] This drug has also been reported to cause psychosis as a significant side effect in patients with DLB. 63,64 If the motor syndrome is tolerable in patients with DLB, the treatment with Levodopa should be avoided. 66 Nevertheless, clinicians may use low dose of Levodopa if required.…”

Section: Motormentioning

confidence: 99%

Dementia With Lew Body

Pervin

Edwards

Lippa

2015

Am J Alzheimers Dis Other Demen

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Patients who have dementia with Lewy bodies (DLB) and undergo surgery may develop aggravated postoperative cognitive dysfunction or postoperative delirium. Many patients with DLB respond poorly to surgery and anesthesia, and their conditions may worsen if they have other medical complications along with dementia. They may also face high risk of prolonged hospital stay, increased medical problems and/or mortality, causing significant physical, psychosocial, and financial burdens on individuals, family members, and society. Anesthesia, pain medications, old age, and surgery-related stresses are usually held responsible for the complications; however, the exact causes are still not fully understood. Literature on surgery-related complications for patients with DLB appears to be inadequate, and hence the topic merits detailed and systematic research. This article reviews postoperative complications and various surgery-related risk factors for DLB in light of other dementias such as Alzheimer's disease, as their neuropathologic features overlap with those of DLB.

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Levodopa response in dementia with lewy bodies: A 1-year follow-up study

Cited by 48 publications

References 20 publications

Clinical features of dementia with lewy bodies in 35 Chinese patients

Clinical features of dementia with lewy bodies in 35 Chinese patients

The key points for treatment of Parkinsonism in older persons

Dementia With Lew Body

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