News Round-Up 2009

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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