RESUMEN
It is currently unknown whether patients with dementia with Lewy bodies (DLB) with relatives with dementia or Parkinson's disease (familial DLB patients) have a different phenotype than sporadic DLB patients. In this study, we aimed to examine disease onset, rate of cognitive decline, survival, and Alzheimer's disease (AD) biomarkers in patients with familial DLB (nâ=â154) and sporadic DLB (nâ=â137), using linear mixed model analysis and Cox regression analysis, among others. Familial patients had a shorter survival (8.0 years) and more often elevated cerebrospinal fluid AD biomarkers (47%) than sporadic patients (9.0 years; p≤0.001; 30%, pâ=â0.037). Our findings suggest that genetic factors are important in DLB and that the identification of new genetic factors will probably improve the prediction of prognosis.
Asunto(s)
Enfermedad por Cuerpos de Lewy/diagnóstico por imagen , Edad de Inicio , Anciano , Anciano de 80 o más Años , Enfermedad de Alzheimer/líquido cefalorraquídeo , Biomarcadores/líquido cefalorraquídeo , Disfunción Cognitiva , Familia , Femenino , Humanos , Estimación de Kaplan-Meier , Enfermedad por Cuerpos de Lewy/epidemiología , Masculino , Persona de Mediana Edad , Fenotipo , Pronóstico , Estudios Retrospectivos , Análisis de SupervivenciaRESUMEN
AIMS: To determine whether the pentagon copying test (PCT) and the clock drawing test (CDT) are associated with nursing home admission or survival in dementia with Lewy bodies (DLB). METHODS: The PCT and/or the CDT were retrospectively collected from 103 clinically diagnosed probable DLB patients at a university medical center and general hospital. Patients with high versus low scores on these tests were compared. RESULTS: Kaplan-Meier analysis showed that patients with a low score on the PCT had a shorter time to nursing home admission than patients with a high score (log-rank χ2 = 6.1, p = 0.01). Patients with a low score on the PCT or the CDT had a shorter survival than patients with a high score (log-rank χ2 = 5.4, p = 0.02, and log-rank χ2 = 11.2, p < 0.001, respectively). Cox regression analyses showed the same associations with an HR of 2.2 (95% CI 1.2-4.1) for the PCT and an HR of 2.9 (95% CI 1.6-5.4) for the CDT. CONCLUSION: The PCT and the CDT may function as prognostic markers in DLB. This finding is clinically relevant as these tests can be applied easily in the clinical setting and can provide valuable prognostic information. Furthermore, it may improve disease management and patient selection for research purposes.
Asunto(s)
Enfermedad por Cuerpos de Lewy/diagnóstico , Pruebas Neuropsicológicas , Anciano , Anciano de 80 o más Años , Enfermedad de Alzheimer/diagnóstico , Femenino , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Casas de Salud , Admisión del Paciente/estadística & datos numéricos , Pronóstico , Estudios Retrospectivos , Factores de RiesgoRESUMEN
A 71-year-old man underwent a coronary angiography (CAG). Afterwards he experienced vision loss. Neurologic examination revealed bilateral cortical blindness. A cerebral CT-scan showed occipital hyperdensity, due to contrast accumulation and oedema. There was complete recovery of vision within 2 days. Transient cortical blindness after CAG is a rare complication of iodinated contrast agents.