Clinicopathological study on early diagnosis of dementia with Lewy bodies

本研究的目的是阐明路易体痴呆（DLB）的前驱状态，并导致DLB的早期诊断和治疗。本研究结果表明，进展为DLB的患者在认知障碍发病前已出现RRM睡眠行为障碍、自主神经症状、嗅觉功能障碍、抑郁等前驱症状，且在具有这些前驱症状的非痴呆或轻度认知障碍患者中，已观察到脑FDG-PET显示初级视觉皮层葡萄糖代谢降低，MIBG心脏闪烁图显示MIBG摄取减少。当有前驱症状的患者在这些功能影像上表现出特征性的发现时，应给予作为前驱DLB患者的预防性治疗。

The aim of this study is to clarify a prodromal state of dementia with Lewy bodies (DLB) and to lead to an early diagnosis and therapy of DLB. From the results of this study, it has been indicated that the patients showing progression to DLB have prodromal symptoms such as RRM sleep behavior disorder, autonomic symptoms, olfactory dysfunction and depression before the onset of cognitive impairment, and that glucose hypometabolism in primary visual cortex on brain FDG-PET and decrease MIBG uptake on MIBG cardiac scintigraphy are already observed in non-demented or mild cognitive impaiment patients with these prodromal symptoms. When patients with prodromal symptoms exhibit characteristic findings on these functional imagings, a preventive therapy should be given for the patients as a prodromal DLB.