Kumiko Utsumi1, Ryo Fukatsu2, Ritsuko Yamada3, Yuji Takamaru4, Yuko Hara2, Shuichi Yasumura5. 1. Department of Psychiatry, Sunagawa City Medical Center, Sunagawa, Japan. 2. Department of Psychiatry, Nishi Kumagaya Hospital, Kumagaya, Japan. 3. School of Nursing and Social Services, Health Sciences University of Hokkaido, Tobetsu, Japan. 4. Department of Psychiatry, Otaru General Hospital, Otaru, Japan. 5. Department of Psychiatry, Sapporo Sato Hospital, Sapporo, Japan.
Abstract
AIM: Although dementia with Lewy bodies (DLB) is characterized by a variety of initial symptoms, there are almost no reports of the initial symptoms of DLB assessed in a large number of cases. We retrospectively evaluated the initial symptoms of 234 participants with DLB and DLB-related symptoms at diagnosis and characterized any gender differences in the symptom profiles. METHODS: This study consisted of 234 participants with probable DLB who met the diagnostic criteria outlined in the Fourth Consensus Report of the DLB Consortium (2017). DLB was confirmed based on several characteristic biomarkers for dopamine transporter imaging with 123 I-N-omega-fluoropropyl-2-beta-carbomethoxy-3-beta (4-iodophenyl) nortropane single-photon emission computed tomography, 123 I-metaiodobenzylguanidine myocardial scintigraphy, and brain perfusion measured with single photon emission computed tomography. In addition, core and supportive clinical features were considered in the diagnosis. RESULTS: Initial symptoms included cognitive impairment (41.9%) and psychiatric symptoms (i.e. visual and auditory hallucinations, delusions, and depression) (42.3%). Almost half of the women initially presented with psychiatric symptoms, with significantly more women than men presenting with auditory hallucinations. In contrast, men had a significantly higher rate of rapid eye movement sleep behaviour disorder (RBD) than women did. At diagnosis, DLB-related symptoms differed between men and women, with male patients exhibiting significantly more RBD, parkinsonism, hyposmia, and syncope than female patients. Moreover women presented significantly more often with auditory hallucinations than did men. CONCLUSIONS: Our results indicate that there are gender differences in the initial symptoms of DLB, as well as in the presentation of subsequent symptoms observed at diagnosis. There was a higher incidence of RBD in men, whereas women had a higher incidence of psychotic symptoms.
AIM: Although dementia with Lewy bodies (DLB) is characterized by a variety of initial symptoms, there are almost no reports of the initial symptoms of DLB assessed in a large number of cases. We retrospectively evaluated the initial symptoms of 234 participants with DLB and DLB-related symptoms at diagnosis and characterized any gender differences in the symptom profiles. METHODS: This study consisted of 234 participants with probable DLB who met the diagnostic criteria outlined in the Fourth Consensus Report of the DLB Consortium (2017). DLB was confirmed based on several characteristic biomarkers for dopamine transporter imaging with 123 I-N-omega-fluoropropyl-2-beta-carbomethoxy-3-beta (4-iodophenyl) nortropane single-photon emission computed tomography, 123 I-metaiodobenzylguanidine myocardial scintigraphy, and brain perfusion measured with single photon emission computed tomography. In addition, core and supportive clinical features were considered in the diagnosis. RESULTS: Initial symptoms included cognitive impairment (41.9%) and psychiatric symptoms (i.e. visual and auditory hallucinations, delusions, and depression) (42.3%). Almost half of the women initially presented with psychiatric symptoms, with significantly more women than men presenting with auditory hallucinations. In contrast, men had a significantly higher rate of rapid eye movement sleep behaviour disorder (RBD) than women did. At diagnosis, DLB-related symptoms differed between men and women, with male patients exhibiting significantly more RBD, parkinsonism, hyposmia, and syncope than female patients. Moreover women presented significantly more often with auditory hallucinations than did men. CONCLUSIONS: Our results indicate that there are gender differences in the initial symptoms of DLB, as well as in the presentation of subsequent symptoms observed at diagnosis. There was a higher incidence of RBD in men, whereas women had a higher incidence of psychotic symptoms.
Authors: Parichita Choudhury; Jonathan Graff-Radford; Jeremiah A Aakre; Lincoln Wurtz; David S Knopman; Neill R Graff-Radford; Kejal Kantarci; Leah K Forsberg; Julie A Fields; Otto Pedraza; Qin Chen; Toji Miyagawa; Gregory S Day; Philip Tipton; Rodolfo Savica; Hugo Botha; Christian Lachner; Brynn Dredla; R Ross Reichard; Ronald C Petersen; Dennis W Dickson; Bradley F Boeve; Tanis J Ferman Journal: Alzheimers Dement Date: 2021-11-11 Impact factor: 16.655
Authors: Emily J Tomlinson; Helen Rawson; Elizabeth Manias; Nicole Nikki M Phillips; Peteris Darzins; Alison M Hutchinson Journal: BMJ Open Date: 2021-07-07 Impact factor: 2.692