Neurological Sciences

, Volume 38, Issue 1, pp 83–91 | Cite as

The Italian dementia with Lewy bodies study group (DLB-SINdem): toward a standardization of clinical procedures and multicenter cohort studies design

  • L. Bonanni
  • A. Cagnin
  • F. Agosta
  • C. Babiloni
  • B. Borroni
  • M. Bozzali
  • A. C. Bruni
  • M. Filippi
  • D. Galimberti
  • R. Monastero
  • C. Muscio
  • L. Parnetti
  • D. Perani
  • L. Serra
  • V. Silani
  • P. Tiraboschi
  • A. Padovani
  • On behalf of DLB-SINdem study group
Original Article

Abstract

Dementia with Lewy bodies (DLB) causes elevated outlays for the National Health Systems due to high institutionalization rate and patients’ reduced quality of life and high mortality. Furthermore, DLB is often misdiagnosed as Alzheimer’s disease. These data motivate harmonized multicenter longitudinal cohort studies to improve clinical management and therapy monitoring. The Italian DLB study group of the Italian Neurological Society for dementia (SINdem) developed and emailed a semi-structured questionnaire to 572 national dementia centers (from primary to tertiary) to prepare an Italian large longitudinal cohort. The questionnaire surveyed: (1) prevalence and incidence of DLB; (2) clinical assessment; (3) relevance and availability of diagnostic tools; (4) pharmacological management of cognitive, motor, and behavioural disturbances; (5) causes of hospitalization, with specific focus on delirium and its treatment. Overall, 135 centers (23.6 %) contributed to the survey. Overall, 5624 patients with DLB are currently followed by the 135 centers in a year (2042 of them are new patients). The percentage of DLB patients was lower (27 ± 8 %) than that of Alzheimer’s disease and frontotemporal dementia (56 ± 27 %) patients. The majority of the centers (91 %) considered the clinical and neuropsychological assessments as the most relevant procedure for a DLB diagnosis. Nonetheless, most of the centers has availability of magnetic resonance imaging (MRI; 95 %), electroencephalography (EEG; 93 %), and FP-CIT single photon emission-computerized tomography (SPECT; 75 %) scan for clinical applications. It will be, therefore, possible to recruit a large harmonized Italian cohort of DLB patients for future cross-sectional and longitudinal multicenter studies.

Keywords

Dementia with Lewy bodies Standardization of diagnostic procedures Survey 

References

  1. 1.
    McKeith IG, Dickson DW, Lowe J et al (2009) Diagnosis and management of Dementia with Lewy bodies: third report of the DLB Consortium. Neurology 65:1863–1872 (Erratum in: Neurology 65:1992) CrossRefGoogle Scholar
  2. 2.
    Merdes AR, Hansen LA, Jeste DV, Galasko D, Hofstetter CR, Ho GJ et al (2003) Influence of Alzheimer pathology on clinical diagnostic accuracy in Dementia with Lewy bodies. Neurology 60:1586–1590CrossRefPubMedGoogle Scholar
  3. 3.
    Walker Z, Jaros E, Walker RWH, Lee L, Costa DC, Livingston G et al (2007) Dementia with Lewy bodies: a comparison of clinical diagnosis, (123)I-FP-CIT SPECT imaging and autopsy. J Neurol Neurosurg Psychiatry 78:1176–1181CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Mok W, Chow TW, Zheng L, Mack WJ, Miller C (2004) Clinicopathological concordance of dementia diagnoses by community versus tertiary care clinicians. Am J Alzheimers Dis Other Demen 19:161–165CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Toledo JB, Cairns NJ, Da X, Chen K, Carter D, Fleisher A, the Alzheimer’s Disease Neuroimaging Initiative (ADNI) (2013) Clinical and multimodal biomarker correlates of ADNI neuropathological findings. Acta Neuropathol Commun 1:65CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Walker Z, Possin KL, Boeve BF, Aarsland D (2015) Lewy body dementias. Lancet 386:1683–1697CrossRefPubMedGoogle Scholar
  7. 7.
    Ballard C, Grace J, McKeith I, Holmes C (1998) Neuroleptic sensitivity in Dementia with Lewy bodies and Alzheimer’s disease. Lancet 351:1032–1033CrossRefPubMedGoogle Scholar
  8. 8.
    Olichney J, Galasko D, Salmon R, Hofstetter CR, Hansen LA, Katzman R, Thal LJ (1998) Cognitive decline is faster in the Lewy body variant of Alzheimer’s disease. Neurology 51:351–357CrossRefPubMedGoogle Scholar
  9. 9.
    Rongve A, Vossius C, Nore S, Testad I, Aarsland D (2014) Time until nursing home admission in people with mild dementia: comparison of Dementia with Lewy bodies and Alzheimer’s dementia. Int J Geriatr Psychiatry 29:392–398CrossRefPubMedGoogle Scholar
  10. 10.
    Levy R, Eagger S, Griffiths M, Perry E, Honavar M, Dean A, Lantos P (1994) Lewy bodies and response to tacrine in Alzheimer’s disease. Lancet 343:176CrossRefPubMedGoogle Scholar
  11. 11.
    Garcia-Ptacek S, Farahmand B, Kåreholt I, Religa D, Cuadrado ML, Eriksdotter M (2014) Mortality risk after dementia diagnosis by dementia type and underlying factors: a cohort of 15,209 patients based on the Swedish Dementia Registry. J Alzheimers Dis 41:467–477. doi:10.3233/JAD-131856 PubMedGoogle Scholar
  12. 12.
    O’Brien JT, McKeith IG, Walker Z, Tatsch K, Booij J, Darcourt J, Marquardt M, Reininger C, for the DLB Study Group (2009) Diagnostic accuracy of 123I-FP-CIT SPECT in possible Dementia with Lewy bodies. Br J Psychiatry 194:34–39CrossRefPubMedGoogle Scholar
  13. 13.
    Walker Z, Moreno E, Thomas A, Inglis F, Tabet N, Rainer M, Pizzolato G, Padovani A, on behalf of the DaTSCAN DLB Phase 4 Study Group (2015) Clinical usefulness of dopamine transporter SPECT imaging with 123I-FP-CIT in patients with possible Dementia with Lewy bodies: randomised study. Br J Psychiatry 206:145–152CrossRefPubMedGoogle Scholar
  14. 14.
    McKeith I, O’Brien J, Walker Z, Tatsch K, Booij J, Darcourt J, Padovani A, Giubbini R, Bonuccelli U, Volterrani D, Holmes C, Kemp P, Tabet N, Meyer I, Reininger C, DLB Study Group (2007) Sensitivity and specificity of dopamine transporter imaging with 123I-FP-CIT SPECT in Dementia with Lewy bodies: a phase III, multicentre study. Lancet Neurol 6:305–313CrossRefPubMedGoogle Scholar
  15. 15.
    Breitve MH, Hynninen MJ, Brønnick K, Chwiszczuk LJ, Auestad BH, Aarsland D, Rongve A (2016) A longitudinal study of anxiety and cognitive decline in Dementia with Lewy bodies and Alzheimer’s disease. Alzheimers Res Ther 8:3CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Yoon JH, Kim M, Moon SY, Yong SW, Hong JM (2015) Olfactory function and neuropsychological profile to differentiate Dementia with Lewy bodies from Alzheimer’s disease in patients with mild cognitive impairment: a 5-year follow-up study. J Neurol Sci 355:174–179CrossRefPubMedGoogle Scholar
  17. 17.
    Cagnin A, Bussè C, Jelcic N, Gnoato F, Mitolo M, Caffarra P (2015) High specificity of MMSE pentagon scoring for diagnosis of prodromal Dementia with Lewy bodies. Parkinsonism Relat Disord 21:303–305CrossRefPubMedGoogle Scholar
  18. 18.
    Firbank MJ, Watson R, Mak E, Aribisala B, Barber R, Colloby SJ, He J, Blamire AM, O’Brien JT (2016) Longitudinal diffusion tensor imaging in Dementia with Lewy bodies and Alzheimer’s disease. Parkinsonism Relat Disord 24:76–80CrossRefPubMedGoogle Scholar
  19. 19.
    Cerami C, Della Rosa PA, Magnani G, Santangelo R, Marcone A, Cappa SF, Perani D (2014) Brain metabolic maps in Mild Cognitive Impairment predict heterogeneity of progression to dementia. Neuroimage Clin 7:187–194CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Bird T, Knopman D, VanSwieten J, Rosso S, Feldman H, Tanabe H et al (2003) Epidemiology and genetics of frontotemporal dementia/Pick’s disease. Ann Neurol 54:S29–S31CrossRefPubMedGoogle Scholar
  21. 21.
    Borroni B, Turrone R, Galimberti D, Nacmias B, Alberici A, Benussi A et al (2015) Italian frontotemporal dementia network (FTD group-SINDEM): sharing clinical and diagnostic procedures in frontotemporal dementia in Italy. Neurol Sci 36:751–757CrossRefPubMedGoogle Scholar
  22. 22.
    Tiraboschi P, Salmon DP, Hansen LA, Hofstetter RC, Thal LJ, Corey-Bloom J (2006) What best differentiates Lewy body from Alzheimer’s disease in early-stage dementia? Brain 129(Pt 3):729–735CrossRefPubMedGoogle Scholar
  23. 23.
    McCleery J, Morgan S, Bradley KM, Noel-Storr AH, Ansorge O, Hyde C (2015) Dopamine transporter imaging for the diagnosis of Dementia with Lewy bodies. Cochrane Database Syst Rev 1:CD010633PubMedGoogle Scholar
  24. 24.
    Seppi K, Weintraub D, Coelho M, Perez-Lloret S, Fox SH, Katzenschlager R, Hametner EM, Poewe W, Rascol O, Goetz CG, Sampaio C (2011) The movement disorder society evidence-based medicine review update: treatments for the non-motor symptoms of Parkinson’s disease. Mov Disord 26(Suppl 3):S42–S80CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag Italia 2016

Authors and Affiliations

  • L. Bonanni
    • 1
  • A. Cagnin
    • 2
    • 14
  • F. Agosta
    • 3
  • C. Babiloni
    • 4
    • 15
  • B. Borroni
    • 5
  • M. Bozzali
    • 6
  • A. C. Bruni
    • 7
  • M. Filippi
    • 3
  • D. Galimberti
    • 8
  • R. Monastero
    • 9
  • C. Muscio
    • 10
  • L. Parnetti
    • 11
  • D. Perani
    • 12
  • L. Serra
    • 6
  • V. Silani
    • 13
    • 16
  • P. Tiraboschi
    • 10
  • A. Padovani
    • 5
  • On behalf of DLB-SINdem study group
  1. 1.Department of Neuroscience Imaging and Clinical SciencesUniversity G.d’Annunzio of Chieti-PescaraChietiItaly
  2. 2.Department of NeurosciencesUniversity of PadovaPaduaItaly
  3. 3.Division of Neuroscience, Neuroimaging Research Unit, and Department of Neurology, Institute of Experimental NeurologySan Raffaele Scientific InstituteMilanItaly
  4. 4.Department of Physiology and PharmacologyUniversity of Rome “La Sapienza”RomeItaly
  5. 5.Neurology Unit, Department of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
  6. 6.Neuroimaging LaboratoryIRCCS Santa Lucia FoundationRomeItaly
  7. 7.Centro Regionale di Neurogenetica ASP CZLamezia TermeItaly
  8. 8.Neurology Unit, Deptartment of Pathophysiology and Transplantation, Fondazione Ca’ Granda, IRCCS Ospedale PoliclinicoUniversity of MilanMilanItaly
  9. 9.Department of Experimental Biomedicine and Clinical Neuroscience (BioNeC)University of PalermoPalermoItaly
  10. 10.Divisione di Neurologia V e NeuropatologiaFondazione IRCCS Istituto Neurologico “Carlo Besta”MilanItaly
  11. 11.Clinica Neurologica, Centro Disturbi della MemoriaUniversità di Perugia (I)PerugiaItaly
  12. 12.Division of Neuroscience, Nuclear Medicine Unit San Raffaele Hospital, San Raffaele Scientific InstituteVita-Salute San Raffaele UniversityMilanItaly
  13. 13.Department of Neurology-Stroke Unit and Laboratory of NeuroscienceIRCCS Istituto Auxologico ItalianoMilanItaly
  14. 14.IRCCS San Camillo Hospital FoundationVeniceItaly
  15. 15.IRCCS San Raffaele PisanaRomeItaly
  16. 16.Department of Pathophysiology and Transplantation, “Dino Ferrari” CenterUniversità degli Studi di MilanoMilanItaly

Personalised recommendations