BACKGROUND: Although dementia with Lewy bodies (DLB) is the second most common form of neurodegenerative dementia after Alzheimer's disease (AD), the clinical diagnosis is frequently difficult. Because both REM sleep behavior disorders and Parkinson's disease also have alpha-synucleinopathy similar to DLB, and show an increase in periodic limb movements (PLM), we evaluated the association between DLB and PLM, which may serve as an additional information to differentiate AD and DLB. METHODS: Overnight polysomnographic recordings were performed for the inpatients in our hospital who were suspected to have dementia. The quality of sleep, oxygen-desaturation index and periodic limb movements were compared among the patients clinically diagnosed with DLB, AD or as having no dementia. RESULTS: Nine DLB patients, twelve AD patients and ten non-demented patients were enrolled in the study. The number of PLM during sleep per hour of total sleep time (PLMS index) was significantly higher in the DLB patients than the AD patients or the non-demented patients. No significant differences were found between the AD patients and the non-demented patients. To differentiate DLB from AD, a PLMS index of more than 15.0 had a sensitivity of 88.9% and a specificity of 83.3%. CONCLUSIONS: The DLB patients exhibited a higher PLMS index than the AD patients, and this index could be clinically useful for the diagnostic differentiation of DLB from AD.
BACKGROUND: Although dementia with Lewy bodies (DLB) is the second most common form of neurodegenerative dementia after Alzheimer's disease (AD), the clinical diagnosis is frequently difficult. Because both REM sleep behavior disorders and Parkinson's disease also have alpha-synucleinopathy similar to DLB, and show an increase in periodic limb movements (PLM), we evaluated the association between DLB and PLM, which may serve as an additional information to differentiate AD and DLB. METHODS: Overnight polysomnographic recordings were performed for the inpatients in our hospital who were suspected to have dementia. The quality of sleep, oxygen-desaturation index and periodic limb movements were compared among the patients clinically diagnosed with DLB, AD or as having no dementia. RESULTS: Nine DLB patients, twelve ADpatients and ten non-demented patients were enrolled in the study. The number of PLM during sleep per hour of total sleep time (PLMS index) was significantly higher in the DLB patients than the ADpatients or the non-demented patients. No significant differences were found between the ADpatients and the non-demented patients. To differentiate DLB from AD, a PLMS index of more than 15.0 had a sensitivity of 88.9% and a specificity of 83.3%. CONCLUSIONS: The DLB patients exhibited a higher PLMS index than the ADpatients, and this index could be clinically useful for the diagnostic differentiation of DLB from AD.