nnpNeurology, Neuropsychiatry, PsychosomaticsНеврология, нейропсихиатрия, психосоматика2074-27112310-1342"IMA-Press", LLC10.14412/2074-2711-2012-356nnp-326Research ArticleArticlesСтатьиLewy body dementia: clinical manifestations, diagnosis, and treatmentДеменция с тельцами Леви: клинические проявления, диагностика и лечениеPreobrazhenskayaIrina SergeyevnaPreobrazhenskayaIrina Sergeyevna

Department of Nervous Diseases, Faculty of Therapeutics

Department of Nervous Diseases, Faculty of Therapeutics

IrinaSP2@yandex.ru20121503201241NO1 (2012)1622Copyright © Preobrazhenskaya I.S., 20122012Preobrazhenskaya I.S.Preobrazhenskaya I.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://nnp.ima-press.net/nnp/article/view/326

Lewy body dementia (LBD) is a disease that was separated from a group of senile dementia in the 1990s. The paper details the pathogenesis, pathomorphology, and clinical manifestations of the disease, as well as a possible association of its symptoms with the specific features of the extent of the neurodegenerative process. It also fully describes mental disorders in LBD, their possible causes, an association of hallucinosis with lesion of nonspecific cerebral systems and mediator failure. The results of LBD treatment with basic symptomatic therapy are given. The results of the clinical trial of the activity of akatinol memantine in the patients with LBD are described in detail.

Деменция с тельцами Леви (ДТЛ) — заболевание, выделенное из группы сенильной деменции в 90-е годы прошлого века. В статье подробно обсуждаются патогенез, патоморфология и клинические проявления данного заболевания, а также возможная связь симптомов болезни и особенностей распространения нейродегенеративного процесса. Подробно описаны психические нарушения при ДТЛ, возможные причины из развития, связь галлюциноза с поражением церебральных неспецифических систем и медиаторной недостаточностью. Приведены результаты лечения ДТЛ препаратами базовой симптоматической терапии. Подробно описаны результаты клинического исследования, посвященного активности акатинола мемантина у пациентов с ДТЛ.

деменция с тельцами ЛевисимптомыдиагностикалечениеLewy body dementiasymptomsdiagnosistreatmentReferences<div><p>O’Brien J., Mc Keith I., Ames D. et al. Dementia with Lewy bodies and Parkinson’s disease dementia. London: Taylor &amp; Francis, 2006;264.</p><p>Kosaka K., Iseki E. Dementia with Lewy bodies. Curr Opin Neurol 1996;9(4):971—5.</p><p>Ballard C., O'Brien J., Tovee M. Qualitative performance characteristics differentiate dementia with Lewy bodies and Alzheimer's disease. J Neurol Neurosurg Psychiatry 2002;72:565—6.</p><p>Korczyn A.D. Dementia in Parkinson's disease. J Neurol 2001;248(Suppl. 3):III/1—III/4.</p><p>Lippa C.F., Smith T.W., Nee L. et al. Familial Alzheimer's disease and cortical Lewy bodies: is there a genetic susceptibility factor? Dementia 1995;6(4):191—4.</p><p>Mc Shane R., Gedling K., Reading M. et al. Prospective study of relations between cortical Lewy bodies, poor eyesight, and hallucinations in Alzheimer's disease. J Neurol Neurosurg Psychiatry 1995;59(2):185—8.</p><p>Rezaie P., Cairns N.J., Chadwick A. et al. Lewy bodies are located preferentially in limbic areas in diffuse Lewy body disease. Neurosci Lett 1996;212(2):111—4.</p><p>Robles A., Rodriguez R.M., Aldrey J.M. et al. Clinical diagnosis of dementia associated with cortical Lewy bodies. Rev Neurol 1995;23(119):62—6.</p><p>Mc Keith I.G., Galasko D., Kosaka K. et al. Consensus guidelines for the clinical and pathologic diagnosis of dementia with Lewy bodies (DLB): report of the consortium on DLB international workshop. Neurology 1996;47(5):1113—24.</p><p>McKeith I.G., Ballard C.G., Perry R.H. et al. Prospective validation of Consensus criteria for the diagnosis of dementia with Lewy bodies. Neurology 2001;57:1497—9.</p><p>Mc Keith I.G., Fairbairn A.F., Bothwell R.A. et al. An evaluation of the pre dictive validity and inter-rater reliability of clinical diagnostic criteria for senile dementia of Lewy body type. Neurology 1994;44(5):872—7.</p><p>MacKeith I.G., Perry E.C., Perry R.H. Report of the second dementia with Lewy body international workshop: diagnosis and treatment. Consorcium on dementia with Lewy bodies. Neurology 1999;53:902—5.</p><p>Ince P.G., Mc Arthur F.K., Bjertness E. et al. Neuropathological diagnoses in elderly patients in Oslo: Alzheimer's disease, Lewy body disease, vascular lesions. Dementia 1995;6(3):162—8.</p><p>L. Knuffman, F. Mohsin, J. Feder et al. Differetiating between Lewy body dementia and Alzheimer's disease: a retrospective brain bank study. JAMDA 2001;146—8.</p><p>Яхно Н.Н. Когнитивные расстройства в неврологической клинике. Неврол журн 2006;11(Прил. 1):4—12.</p><p>Яхно Н.Н., Дамулин И.В., Мхитарян Э.А. Болезнь Альцгеймера и деменция с тельцами Леви: некоторые аспекты клиники, диагностики и лечения. РМЖ 2003;10(11):567—70.</p><p>Яхно Н.Н., Преображенская И.С. Деменция с тельцами Леви. Неврол журн 2003;8(6):4-12.</p><p>Doubleday E.C., Snowden J.S., Warma A.R. et al. Qualitative performance characteristics differentiate dementia with Lewy bodies and Alzheimer's disease. J Neurol Neurosurg Psychiatry 2002;72:602-7.</p><p>Преображенская И.С. Деменция с тельцами Леви. Дисс. ... докт. мед. наук. М., 2005;367 с.</p><p>Pellise A., Roig C., Barraquer-Bordas L.I. et al. Abnormal, ubiquitinated cortical neurites in patients with diffuse Lewy body disease. Neurosci Lett 1996;206(2-3):85-8.</p><p>Яхно Н.Н., Захаров В.В., Локшина А.Б. и др. Деменции. Рук-во для врачей. 2-е изд. М.: Медпресс-информ, 2010;272 с.</p><p>Weiner M.F., Risser R.C., Cullum C.M. et al. Alzheimer's disease and its Lewy body variant: a clinical analysis of postmortem verified cases. Am J Psychiatry 1996;153(10):1269—73.</p><p>Gnanalingham K.K., Byrne E.J., Thornton A. et al. Motor and cognitive function in Lewy body dementia: comparison with Alzheimer's and Parkinson's disease. J Neurol Neurosurg Psychiatry 1997;62:243—52.</p><p>Ransmayr G., Seppi K., Donnemiller E. et al. Striatal dopamine transporter function in dementia with Lewy bodies and Parkinson's dosease. Eur J Nucl Med 2001;28:1523-8.</p><p>Преображенская И.С., Мхитарян Э.А., Яхно Н.Н. Сравнительный анализ когнитивных нарушений при деменции с тельцами Леви и болезни Альцгеймера. Журн невропатол и психиатр 2005;105(1):20—5.</p><p>Del Ser T., Yachinski V., Merskey H. et al. Clinical and pathological features of two groups of patients with dementia with Lewy bodies: effect of coexisting Alzheimer-type lesion load. Alz dis assoc dis 2001;1(1):31—44.</p><p>Calderon M., Perry R.J., Erzinclioglu S.W. et al. Perception, attention, and working memory are disproportionately impaired in dementia with Lewy bodies compared with Alzheimer's disease. J Neurol Neurosurg Psychiatry 2001;70:157-64.</p><p>Yoshita M., Taki J., Yamada M. A clinical role for [123I]MIBG myocardial scintigraphy in the distinction between dementia of the Alzheimer’s-type and dementia with Lewy bodies. J Neurol Neurosurg Psychiatry 2001;71:583—8.</p><p>Тишкова И.Г., Преображенская И.С. Анализ вариабельности сердечного ритма у пациентов с деменцией с тельцами Леви и болезнью Паркинсона. Неврол, нейропсихиатр, психосом 2011;1:46-51.</p></div><br /><div><p>O’Brien J., Mc Keith I., Ames D. et al. Dementia with Lewy bodies and Parkinson’s disease dementia. London: Taylor &amp; Francis, 2006;264.</p><p>Kosaka K., Iseki E. Dementia with Lewy bodies. Curr Opin Neurol 1996;9(4):971—5.</p><p>Ballard C., O'Brien J., Tovee M. Qualitative performance characteristics differentiate dementia with Lewy bodies and Alzheimer's disease. J Neurol Neurosurg Psychiatry 2002;72:565—6.</p><p>Korczyn A.D. Dementia in Parkinson's disease. J Neurol 2001;248(Suppl. 3):III/1—III/4.</p><p>Lippa C.F., Smith T.W., Nee L. et al. Familial Alzheimer's disease and cortical Lewy bodies: is there a genetic susceptibility factor? Dementia 1995;6(4):191—4.</p><p>Mc Shane R., Gedling K., Reading M. et al. Prospective study of relations between cortical Lewy bodies, poor eyesight, and hallucinations in Alzheimer's disease. J Neurol Neurosurg Psychiatry 1995;59(2):185—8.</p><p>Rezaie P., Cairns N.J., Chadwick A. et al. Lewy bodies are located preferentially in limbic areas in diffuse Lewy body disease. Neurosci Lett 1996;212(2):111—4.</p><p>Robles A., Rodriguez R.M., Aldrey J.M. et al. Clinical diagnosis of dementia associated with cortical Lewy bodies. Rev Neurol 1995;23(119):62—6.</p><p>Mc Keith I.G., Galasko D., Kosaka K. et al. Consensus guidelines for the clinical and pathologic diagnosis of dementia with Lewy bodies (DLB): report of the consortium on DLB international workshop. Neurology 1996;47(5):1113—24.</p><p>McKeith I.G., Ballard C.G., Perry R.H. et al. Prospective validation of Consensus criteria for the diagnosis of dementia with Lewy bodies. Neurology 2001;57:1497—9.</p><p>Mc Keith I.G., Fairbairn A.F., Bothwell R.A. et al. An evaluation of the pre dictive validity and inter-rater reliability of clinical diagnostic criteria for senile dementia of Lewy body type. Neurology 1994;44(5):872—7.</p><p>MacKeith I.G., Perry E.C., Perry R.H. Report of the second dementia with Lewy body international workshop: diagnosis and treatment. Consorcium on dementia with Lewy bodies. Neurology 1999;53:902—5.</p><p>Ince P.G., Mc Arthur F.K., Bjertness E. et al. Neuropathological diagnoses in elderly patients in Oslo: Alzheimer's disease, Lewy body disease, vascular lesions. Dementia 1995;6(3):162—8.</p><p>L. Knuffman, F. Mohsin, J. Feder et al. Differetiating between Lewy body dementia and Alzheimer's disease: a retrospective brain bank study. JAMDA 2001;146—8.</p><p>Яхно Н.Н. Когнитивные расстройства в неврологической клинике. Неврол журн 2006;11(Прил. 1):4—12.</p><p>Яхно Н.Н., Дамулин И.В., Мхитарян Э.А. Болезнь Альцгеймера и деменция с тельцами Леви: некоторые аспекты клиники, диагностики и лечения. РМЖ 2003;10(11):567—70.</p><p>Яхно Н.Н., Преображенская И.С. Деменция с тельцами Леви. Неврол журн 2003;8(6):4-12.</p><p>Doubleday E.C., Snowden J.S., Warma A.R. et al. Qualitative performance characteristics differentiate dementia with Lewy bodies and Alzheimer's disease. J Neurol Neurosurg Psychiatry 2002;72:602-7.</p><p>Преображенская И.С. Деменция с тельцами Леви. Дисс. ... докт. мед. наук. М., 2005;367 с.</p><p>Pellise A., Roig C., Barraquer-Bordas L.I. et al. Abnormal, ubiquitinated cortical neurites in patients with diffuse Lewy body disease. Neurosci Lett 1996;206(2-3):85-8.</p><p>Яхно Н.Н., Захаров В.В., Локшина А.Б. и др. Деменции. Рук-во для врачей. 2-е изд. М.: Медпресс-информ, 2010;272 с.</p><p>Weiner M.F., Risser R.C., Cullum C.M. et al. Alzheimer's disease and its Lewy body variant: a clinical analysis of postmortem verified cases. Am J Psychiatry 1996;153(10):1269—73.</p><p>Gnanalingham K.K., Byrne E.J., Thornton A. et al. Motor and cognitive function in Lewy body dementia: comparison with Alzheimer's and Parkinson's disease. J Neurol Neurosurg Psychiatry 1997;62:243—52.</p><p>Ransmayr G., Seppi K., Donnemiller E. et al. Striatal dopamine transporter function in dementia with Lewy bodies and Parkinson's dosease. Eur J Nucl Med 2001;28:1523-8.</p><p>Преображенская И.С., Мхитарян Э.А., Яхно Н.Н. Сравнительный анализ когнитивных нарушений при деменции с тельцами Леви и болезни Альцгеймера. Журн невропатол и психиатр 2005;105(1):20—5.</p><p>Del Ser T., Yachinski V., Merskey H. et al. Clinical and pathological features of two groups of patients with dementia with Lewy bodies: effect of coexisting Alzheimer-type lesion load. Alz dis assoc dis 2001;1(1):31—44.</p><p>Calderon M., Perry R.J., Erzinclioglu S.W. et al. Perception, attention, and working memory are disproportionately impaired in dementia with Lewy bodies compared with Alzheimer's disease. J Neurol Neurosurg Psychiatry 2001;70:157-64.</p><p>Yoshita M., Taki J., Yamada M. A clinical role for [123I]MIBG myocardial scintigraphy in the distinction between dementia of the Alzheimer’s-type and dementia with Lewy bodies. J Neurol Neurosurg Psychiatry 2001;71:583—8.</p><p>Тишкова И.Г., Преображенская И.С. Анализ вариабельности сердечного ритма у пациентов с деменцией с тельцами Леви и болезнью Паркинсона. Неврол, нейропсихиатр, психосом 2011;1:46-51.</p></div><br />

The authors declare that there are no conflicts of interest present.