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루이소체 치매의 개정 진단기준 및 치료의 고찰

New Diagnostic Criteria and Treatment for Dementia with Lewy Bodi

노인정신의학 2020년 24권 2호 p.60 ~ 68
손보경, 이동우,
소속 상세정보
손보경 ( Sohn Bo-Kyung ) - Inje University Sanggye Paik Hospital Department of Psychiatry
이동우 ( Lee Dong-Woo ) - Inje University Sanggye Paik Hospital Department of Psychiatry

Abstract


Dementia with Lewy bodies (DLB) is the second most common cause of neurodegenerative dementia. The Dementia with Lewy Bodies Consortium has revised DLB consensus diagnostic criteria. We reviewed recent (fourth) clinical diagnosis criteria and treatment options. The revised DLB clinical criteria included clinical features and updated diagnostic biomarkers. Compared with third criteria, they removed suggestive features and reassigned rapid eye movement sleep behavior disorder (RBD) in core clinical features with fluctuating cognition, recurrent visual hallucination, and parkinsonism. They classified biomarkers into two groups, indicative and supportive biomarkers, according to diagnostic specificity and evidence quality. Indicative biomarkers included reduced dopamine transporter uptake in basal ganglia demonstrated by single-photon emission CT or positron emission tomography, low uptake 123Iodine- metaiodobenzylguanidine myocardial scintigraphy, and RBD in polysomnography. In treatment of DLB, cholinesterase inhibitor can improve cognitive function and activities of daily living. Neuroleptics should use with caution due to sensitivity in DLB.

키워드

Lewy body disease; Dementia; Diagnosis; Biomarkers; Therapeutics

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