Lewy Body Dementia

By Jeff Damm

Lewy body dementia is a complex neurodegenerative pathology, which is characterized by cognitive deficiency, physical degeneration, and psychosis symptoms. It has similar symptoms like that of Parkinson’s and Alzheimer’s diseases which makes it difficult to diagnose or recognize [1]. Lewy body dementia eventually leads to death.

Lewy body dementia, also known as Lewy body disease, is an illness which affects the cognitive part of your brain. It is contributed by abnormal accumulation of proteins called alpha-synuclein that develops in the interior part of brain cells [2]. According to the veteran medical researchers of the United States, the prevalence of Lewy body dementia ranges from 0 to 5 percent of the whole population and from 0 to 0.5 percent collectively of all cases of dementia combined.

The Etiology of Lewy Body Dementia

Lewy body dementia is named after the commemoration of Dr. Friederich Heinrich Lewy who described this disease in the brains of a couple of individuals who died due to Parkinson’s illness.  Lewy bodies are neuronal attachments which are spherical in nature. They generally appear in a protein known as alpha-synuclein and neuronal fibers.

The anomalous accumulation of alpha-synuclein protein in the nerve cells results in the creation of deposits which causes incoherence of messages sent to the brain. Lewy bodies are usually found in the cells positioned at the brain base and play a very vital role of controlling motion in the brain [3]. Lewy bodies can also be found in the exterior layer of the brain known as the cortex which is culpable for mental purposes.

Let us now discuss the three characteristics of Lewy Body Dementia

 

  • Parkinsonism

 

Parkinsonism is a character attributed to Lewy body dementia. The patient suffering from this disease has gait changes, rigidity, masklike faces, bradykinesia, and the propensity of falling.  A patient who shows these kinds of symptoms may be suffering from Lewy body dementia. Patients suffering from this disease have a tendency of responding less favorably compared to levodopa disease.

Parkinsonism is a symptom that usually occurs at the age of 50 to 80 according to research done by the experts of Varsity of Texas Southwestern Medical Center. The causes that are attributed to Parkinsonism include the following:

  • Corticobasal degeneration: this contributes to dementia symptoms and also affects movement on one side of the patient’s body.  An individual may be incapacitated to make muscle movements.
  • Dementia with Lewy bodies: this form causes changes in holistic alertness and causing hallucinations that are visual.
  • Multiple system atrophy: this form causes automatic dysfunction and deficits in brain coordination.
  • Progressive supranuclear palsy: this contributes to dementia symptoms, regular backward falls, and the challenges of rotating the eyes down and up.

 

  • Cognitive Deficiency

 

Cognitive deficiency is a condition of Lewy body dementia which is not only manifested to older people but also seen in young individuals [4]. Cognitive impairment affects the quality of life of the individual. It impacts the capacity for rational thinking, affects language, perception, and causes the inability to solve present problems.

Cognitive deficiency can also be caused by reckless wrong previous medications by the doctors, drug abuse, or withdrawal, hypnosis and sleep deprivation [5]. This condition is called delirium. Other causes that may accelerate the exposure of delirium include poor nutrition, old age, infections of urinary tract, stomach, and skin. Cognitive impartment can also result due to the frequent occurrence of heart issues, brain trauma, and stroke and can deteriorate the functions of the brain.

 

  • Psychosis

 

Psychosis generally means the incomprehension to conceive reality. It’s a symptom of Lewy body dementia which is a mental illness rather than a medical condition of its own accord.

A patient with psychosis symptoms has a number of sensory experiences that are out of existence. In addition, a psychosis patient holds irrational affirmations that cannot be fathomed by a normal mind. In a psychosis situation, a person experiences delusions and hallucinations. An individual may hear or see things that are out of existence, which are hallucinations. Paranoid delusions involve the patient creating a narrative in his/her mind that demonstrates poor reality testing and may make the patient distrusting of others.

Symptoms of Psychosis

  • Hallucinations: seeing, feeling, or hearing things that are out of existence.
  • Delusions: false affirmations, based on suspicion or fear of things that are out of reality.
  • Disorganization: disharmony and incoherence in behavior, speech, or thought
  • Catanonia: this is the condition of unresponsiveness especially when one is in a dialogue with someone.
  • Difficulty concentrating: psychosis symptoms can cause a person to be absent-minded which eventually leads to lack of concentration or focus.

Lewy body dementia is an illness that has caused a lot of deaths worldwide. It is a disease that is difficult for doctors to diagnose because of its symptoms similarity of Parkinson and Alzheimer diseases. A high clinical suspicion is crucial in proper diagnosis. Imaging, such as Pet Scans, along with labs and other neuropsychological data can be used to assess the patient and to make a diagnosis. Positron-emission tomography (Pet Scan)  is a nuclear medicine functional imaging technique that is used to observe metabolic processes in the body as an aid to the diagnosis of disease [6].

People should not take this disease for granted. It is recommended that organizations should collaborate to combat this illness and to find a cure. Guidance, counseling, and support should also be given to patients and their caregivers and loved ones. The EPIC Foundation should be supported by philanthropists, well-wishers, medical doctors and the US government to help in combating Lewy body dementia.

References

  1. Aarsland D, Kurz M, Beyer M, Bronnick K, Nore SP, Ballard C. “Early Discriminatory Diagnosis of Dementia with Lewy Bodies: The Emerging Role of CSF and Imaging Biomarkers.” Dement Geriatr Cogn Disord 2008;25:195–205
  2. Boeve BF, Silber MH, Ferman TJ, et al. “REM sleep behavior disorder and degenerative dementia: an association likely reflecting Lewy body disease.” Neurology 1998; 51:363-370
  3. Dubois B, Burn D, Goetz C, Aarsland D, et al. “Diagnostic procedures for Parkinson’s disease dementia: recommendations from the movement disorder society task force.” Mov Disord. 2007 Dec; 22(16):2314-24
  4. McKeith IG, 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.” Neurol. 1996; 47:1113-1124
  5. Orimo S, Amino T, Ozawa E, et al. “A useful marker for differential diagnosis of Parkinson’s disease–MIBG myocardial scintigraphy.” Rinsho Shinkeigaku 2004; 44:827-829
  6. Positron emission tomography. Retrieved from https://en.wikipedia.org/ (2018)