Re: News Round-Up 2009

[Guest guest]

Thanks for the info, .

Many of the studies listed on the psychiatry blog highlight the importance of

brain donation.

The blogger's list would not be my list of the most important LBD research of

2009. I think the three most important articles are these:

* 2009. This research is on the horrible diagnostic accuracy for " pure

DLB " (32%) and mixed AD/DLB (12%). This study looked at nearly 3K brains from

major research centers around the US. When someone says that they have a loved

one diagnosed with LBD, chances are far better that the person does NOT have

LBD. See:

http://community.lbda.org/forum/viewtopic.php?t=1844

* Molano 2009. This Mayo research explored the relationship between LBD and

mild cognitive impairment. Since there are more people out there diagnosed with

MCI than LBD, I think this research will be important to many clinicians dealing

with MCI. The Mayo team explored who converted from MCI to LBD. See:

http://community.lbda.org/forum/viewtopic.php?t=1713

* STAND-Map study. (It's the only one listed on the blog that I agree is

important.) This Mayo study looked at the clinical and imaging records of

people diagnosed upon brain autopsy with DLB, FTD, and AD. They were able to

come up with unique patterns of atrophy specific to the three disorders. The

specificity is only 80% so we've got a long way to go (99% would be good) but at

least we are getting there. See:

http://community.lbda.org/forum/viewtopic.php?t=1712

If you want to read more about most of the research papers (such as the

abstract, excerpts, key findings) contained in the psychiatry blog that

found, see:

1. Tsuang 2009:

http://community.lbda.org/forum/viewtopic.php?t=1660

2. Piguet 2009:

http://community.lbda.org/forum/viewtopic.php?t=1648

3. STAND-Map study:

http://community.lbda.org/forum/viewtopic.php?t=1712

4. Palmqvist 2009:

http://community.lbda.org/forum/viewtopic.php?t=1483

The only one of these that generated *any* substantive discussion was the Piguet

research. Long ago I concluded that people are not very interested in research!

>

> News Round-Up 2009

> The Amazing World of Psychiatry: A Psychiatry Blog

> December 30, 2009

>

> A relatively large 12-month follow-up study of 325 people who had undergone

123I-FP-CIT-SPECT scans found that the SPECT scans were useful in discriminating

Lewy Body from non-Lewy Body Dementia. A rating panel utilised other clinical

measures of the presentation. These ratings were then compared with the SPECT

scan results. In the probably Lewy Body Dementia group the sensitivity was 63%

and the specificity was 100%. It would be interesting to see the results at two

years.

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> In a prospective study of community-based people with dementia (n=48)

including post-mortem, visual hallucinations were associated with a higher

frequency of neocortical lewy-related pathology, abnormal posture and gait than

those without visual hallucinations. However in 59% of cases the diagnosis was

Alzheimer's Disease with concurrent Lewy Body related pathology (Tsuang et al,

2009). People with Lewy Body Dementia (n=29) were significantly more likely than

those with Alzheimer's Disease (n=33) to report difficulties with swallowing

(Shinagawa et al, 2009). A component of inclusion bodies –

trans-activation-responsive DNA-binding protein 43 (TDP-43) has been found in

familial British Dementia by a Canadian group (Schwab et al, 2009).

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> A retrospective post-mortem study provided further evidence of an overlap

between Alzheimer's Disease, Frontotemporal Dementia and Lewy Body Dementia

using current diagnostic criteria (Piguet et al, 2009).

>

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> In a similar vein, a team at the Mayo Clinic have been developing an MRI

protocol for discriminating Alzheimer's Disease, Frontotemporal Lobar

Degeneration and Lewy Body Dementia. The protocol is referred to as the

STAND-Map protocol (Structural Abnormality Index). The protocol is apparently

effective at discriminating `75-80%' of cases although the results are due to

be presented at a conference and it will be interesting to have a closer look at

the breakdown of figures.

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> In one post-mortem study all subjects with Lewy Bodies were retrospectively

found to be functionally impaired although the calculation of an odds ratio was

not possible (paper freely available here) (Byford et al, 2009).

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> The Swedish Lund group have suggested an aggregate of MMSE scores, clock

drawing test and 3D cube-copying test scores as indicating a further exclusion

of Lewy Body Dementia on the basis of this study of 33 people with Lewy Body

Dementia (Palmqvist et al, 2009).

>

> http://tinyurl.com/ya5efwt

>