Validation of the Neuropathologic Criteria of the Third Consortium for Dementia

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Validation of the Neuropathologic Criteria of the Third Consortium

for Dementia With Lewy Bodies for Prospectively Diagnosed Cases.

July 2008

Abstract:

There is limited information on the validity of the pathologic

criteria of the Third Consortium on Dementia with Lewy bodies (CDLB),

and none are based on prospectively diagnosed cases. In this study,

the core clinical features of dementia with Lewy bodies (DLB) and the

suggestive clinical feature of rapid eye movement sleep behavior

disorder were assessed using a battery of standardized clinical

instruments in 76 patients with the clinical diagnosis of either DLB

or Alzheimer disease. At autopsy, 29 patients had high-likelihood, 17

had intermediate-likelihood, and 6 had low-likelihood DLB pathology.

The frequency of core clinical features and the accuracy of the

clinical diagnosis of probable DLB were significantly greater in high-

likelihood than in low-likelihood cases. This is consistent with the

concept that the DLB clinical syndrome is directly related to Lewy

body pathology and inversely related to Alzheimer pathology. Thus,

the Third Consortium on DLB neuropathologic criteria scheme performed

reasonably well and are useful for estimating the likelihood of the

premortem DLB syndrome based on postmortem findings. In view of

differences in the frequency of clinically probable DLB in cases with

Braak neurofibrillary tangle stages V (90%) and VI (20%) and diffuse

cortical Lewy bodies, a possible modification of the scheme is to

consider cases with neurofibrillary tangle stage VI to be low-

likelihood DLB.

© 2008 American Association of Neuropathologists, Inc

Source:

http://tinyurl.com/3nouzx