Inclusion of RBD improves the diagnostic classification of dementia with Lewy bodies
Inclusion of RBD improves the diagnostic classification of dementia with Lewy bodies
复制标题
DOI：
10.1212/wnl.0b013e31822c9148
复制
发表时间：
2011-08-01
期刊：
影响因子：
9.9
通讯作者：
Dickson, D. W.
中科院分区：
文献类型：
--
作者：
Ferman, T. J.;Boeve, B. F.;Dickson, D. W.
Objective: To determine whether adding REM sleep behavior disorder (RBD) to the dementia with Lewy bodies (DLB) diagnostic criteria improves classification accuracy of autopsy-confirmed DLB.Methods: We followed 234 consecutive patients with dementia until autopsy with a mean of 4 annual visits. Clinical diagnoses included DLB, Alzheimer disease (AD), corticobasal syndrome, and frontotemporal dementia. Pathologic diagnoses used the 2005 DLB consensus criteria and included no/low likelihood DLB (non-DLB; n = 136) and intermediate/high likelihood DLB (DLB; n = 98). Regression modeling and sensitivity/specificity analyses were used to evaluate the diagnostic role of RBD.Results: Each of the 3 core features increased the odds of autopsy-confirmed DLB up to 2-fold, and RBD increased the odds by 6-fold. When clinically probable DLB reflected dementia and 2 or more of the 3 core features, sensitivity was 85%, and specificity was 73%. When RBD was added and clinically probable DLB reflected 2 or more of 4 features, sensitivity improved to 88%. When dementia and RBD were also designated as probable DLB, sensitivity increased to 90% while specificity remained at 73%. The VH, parkinsonism, RBD model lowered sensitivity to 83%, but improved specificity to 85%.Conclusions: Inclusion of RBD as a core clinical feature improves the diagnostic accuracy of autopsy-confirmed DLB. Neurology (R) 2011;77:875-882
