Enfermedad con cuerpos de Lewy

  • Jorge Lorenzo Otero Universidad de la República, Facultad de Medicina, Instituto de Neurología, Departamento de Neuropsicología, Profesor Agregado
  • Luis Fontán Scheitler Universidad de la República, Facultad de Medicina, Instituto de Neurología, Departamento de Neuropsicología, Ex Profesor Adjunto
Palabras clave: CUERPOS DE LEWY, ENFERMEDAD POR CUERPOS DE LEWY, ALUCINACIONES

Resumen

El objetivo de esta revisión es poner al día el conocimiento acerca de una patología degenerativa que está considerada como la segunda causa de demencia, luego de la enfermedad de Alzheimer, en los centros que realizan anatomía patológica de modo sistemático. Fue subdiagnosticada del punto de vista clínico en todo el mundo, hasta que recientemente se revisaron sus criterios diagnósticos y anatomopatológicos. Es altamente probable que en nuestro medio permanezca subdiagnosticada.
Este hecho, sumado a su peculiar y grave evolución, justifica su revisión y puesta al día. Se deben considerar, además, las dificultades que los lectores uruguayos tenemos en torno al acceso a las fuentes originales. Se usaron artículos a texto completo y como fuentes complementarias PubMed y Proquest.
Se revisaron revistas científicas con textos en inglés, se consideró la importancia del autor o autores en el tema, así como la relevancia de la revista. Los artículos abarcan un período amplio que se extiende desde fines de la década de 1990 hasta el año 2007. Se hace especial hincapié en los consensos más recientes, considerándolos claves para el diagnóstico clínico.

Citas

(1) Polymeropoulos M, Lavedan C, Leroy E, Ide SE, Dehejia A, Dutra A, et al. Mutation in the alpha-synuclein gene identified in families with Parkinson’s disease. Science 1997; 276: 2045-7.
(2) Spillantini MG, Schmidt ML, Lee VM, Trojanowski JQ, Jakes R, Goedert M. Alpha-synuclein in Lewy bodies. Nature 1997; 388: 839-40.
(3) Jellinger KA. Neuropathological spectrum of synucleinopathies. Mov Disord 2003; Suppl 6: S2-12.
(4) Litvan, I, MacIntyre A, Goetz CG, Wenning GK, Jellinger K, Verny M, et al. Accuracy of the clinical diagnoses of Lewy body disease, parkinson disease, and dementia with Lewy Bodies: a clinicopathologic study. Arch Neurol 1998; 55(7): 969-78.
(5) McKeith IG, Galasko D, Kosaka K, Perry EK, Dickson DW, Hansen LA, 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: 1113-24.
(6) McKeith IG, Dickson DW, Lowe J, Emre M, O’Brien JT, Feldman H, et al. Diagnosis and management of dementia with Lewy bodies. Third report of the DLB consortium. Neurology 2005; 65: 1863-72.
(7) Lippa CF, Duda JE, Grossman M, Hurtig HI, Aarsland D, Boeve BF, et al. DLB and PDD boundary issues: diagnosis, treatment, molecular pathology, and biomarkers. Neurology 2007; 68: 812-9.
(8) Merdes AR, Hansen LA, Jeste DV, Galasko D, Hofstetter CR, Ho GJ, et al. Influence of Alzheimer pathology on clinical diagnostic accuracy in dementia with Lewy bodies. Neurology 2003; 60: 1586-90.
(9) Boeve BF, Silber MH, Ferman TJ, Kokmen E, Smith GE, Ivnik RJ, et al. REM sleep behavior disorder and degenerative dementia: an association likely reflecting Lewy body disease. Neurology 1998; 51: 363-70.
(10) Aarsland D, Litvan I, Salmon D, Galasko D, Wentzel-Larsen T, Larsen JP. Performance on the dementia rating scale in Parkinson’s disease with dementia and dementia with Lewy bodies: comparison with progressive supranuclear palsy and Alzheimer’s disease. J Neurol Neurosurg Psychiatry 2003; 74: 1215-20.
(11) Mosimann UP, Rowan EN, Partington CE, Collerton D, Littlewood E, O’Brien JT, et al. Characteristics of visual hallucinations in Parkinson disease dementia and dementia with Lewy bodies. Am J Geriatr Psychiatry 2006; 14: 153-60.
(12) Aarsland D, Perry R, Larsen JP, McKeith I, O’Brien J. Neuroleptic sensitivity in Parkinson’s disease and parkinsonian dementias. J Clin Psychiatry 2005; 66: 633-7.
(13) Walker MP, Ayre GA, Cummings JL, Wesnes K, McKeith IG, O’Brien JT. The clinician assessment of fluctuation and the one day fluctuation assessment scale. Two methods to assess fluctuating confusion in dementia. Br J Psychiatry 2000; 77: 252-6.
(14) Weintraub D, Hurtig HI. Presentation and management of psychosis in Parkinson’s disease and dementia with Lewy bodies. Am J Psychiatry 2007; 164: 1491-8.
(15) Harding AJ, Broe GA, Halliday GM. Visual hallucinations in Lewy body disease relate to Lewy bodies in the temporal lobe. Brain 2002; 125: 391-403.
(16) Deramecourt V, Bombois S, Maurage CA, Ghestem A, Drobecq H, Vanmechelen E, et al. Biochemical staging of synucleinopathy and amyloidopathy in dementia with Lewy bodies. J Neuropathol Exp Neurol 2006; 65: 278-88.
(17) Singleton A, Gwinn-Hardy K. Parkinson’s disease and dementia with Lewy bodies: a difference in dose? Lancet 2004; 64: 1105-7.
(18) Hamilton RL. Lewy bodies in Alzheimer’s disease: a neuropathological review of 145 cases using alpha-synuclein immunohistochemistry. Brain Pathol 2000; 10: 378-84.
(19) Consensus recommendations for the postmortem diagnosis of Alzheimer’s disease. The National Institute on Aging, and Reagan Institute Working Group on Diagnostic Criteria for the Neuropathologic Assessment of Alzheimer’s Disease. Neurobiol Aging 1997; 18 (4 Suppl): S1-2.
(20) Del Ser T, Hachinski V, Merskey H, Munoz DG. Clinical and pathologic features of two groups of patients with dementia with Lewy bodies: effect of coexisting Alzheimer-type lesion load. Alzheimer Dis Assoc Disord 2001; 15: 31-44.
(21) Merdes AR, Hansen LA, Jeste DV, Galasko D, Hofstetter CR, Ho GJ, et al. Influence of Alzheimer pathology on clinical diagnostic accuracy in dementia with Lewy bodies. Neurology 2003; 60: 1586-90.
(22) López OL, Becher JT, Kaufer DI, Hamilton RL, Sweet RA, Klunk W, et al. Research evaluation and prospective diagnosis of dementia with Lewy bodies. Arch Neurol 2002; 59: 43-6.
(23) Weisman D, Cho M, Taylor C, Adame A, Thal LJ, Hansen LA. In dementia with Lewy bodies, Braak stage determines phenotype, not Lewy body distribution. Neurology 2007; 69: 356-9.
(24) Lippa CF, Fujiwara H, Mann DM, Giasson B, Baba M, Schmidt ML, et al. Lewy bodies contain altered alpha-synuclein in brains of many familial Alzheimer’s disease patients with mutations in presenilin and amyloid precursor protein genes. Am J Pathol 1998; 153: 1365-70.
(25) Trembath Y, Rosenberg C, Ervin JF, Giasson B, Baba M, Schmidt ML, et al. Lewy body pathology is a frequent co-pathology in familial Alzheimer’s disease. Acta Neuropathol 2003; 105: 484-8.
(26) Molloy S, McKeith IG, O’Brien JT, Burn DJ. The role of levodopa in the management of dementia with Lewy bodies. J Neurol Neurosurg Psychiatry 2005; 76: 1200-3.
(27) Wolters EC. Dopaminomimetic psychosis in Parkinson’s disease patients: diagnosis and treatment. Neurology 1999; 52(Suppl 3): S10-3.
(28) Ballard CG, Chalmers KA, Todd C. Cholinesterase inhibitors reduce cortical Abeta in dementia with Lewy bodies. Neurology 2007; 68: 1726-9.
(29) McKeith I, Del Ser T, Spano P, Emre K, Wesnes K, Anand R, et al. Efficacy of rivastigmine in dementia with Lewy bodies: a randomised, double-blind, placebo-controlled international study. Lancet 2000; 356(9247): 2031-6.
(30) Wesnes KA, McKeith IG, Ferrara R. Effects of rivastigmine on cognitive function in dementia with Lewy bodies: a randomised placebo controlled international study using the cognitive drug research computerized assessment system. Dement Geriatr Cogn Disord 2002; 13: 183-92.
(31) Baskys A. Lewy body dementia: the litmus test for neurolelptic sensitivity and extrapyramidal symptoms. J Clin Psychiatry 2004; 65 (Suppl 11): 16-22.
(32) Fernández HH, Trieschmann ME, Burke MA, Friedman JH. Quetiapine for psychosis in Parkinson’s disease versus dementia with Lewy bodies. J Clin Psychiatry 2002; 63(6): 513-5.
(33) Takahashi H, Yoshida K, Sugita T, Higuchi H, Shimizu T. Quetiapine treatment of psychotic symptoms and aggressive behavior in patients with dementia with Lewy bodies: a case series. Prog Neuropsychopharmacol Biol Psychiatry 2003; 27: 549-53.
(34) Ondo WG, Levy JK, Vuong KD, Hunter C, Jankovic J. Olanzapine treatment for dopaminergic-induced hallucinations. Mov Disord 2002; 17:1031-5.
(35) Ellis T, Cudkowicz ME, Sexton PM, Growdon JH. Clozapine and risperidone treatment of psychosis in Parkinson’s disease. J Neuropsychiatry Clin Neurosci 2000; 12: 364-9.
(36) Cummings JL, Street J, Masterman DL, Clark WS. Efficacy of olanzapine in the treatment of psychosis in dementia with Lewy bodies. Dement Geriatr Cogn Disord 2002; 13: 67-73.
(37) Fernández HH, Trieschmann ME, Okun MS. Rebound psychosis: effect of discontinuation of antipsychotics in Parkinson’s disease. Mov Disord 2004; 20:104-15.
Publicado
2008-09-30
Cómo citar
1.
Lorenzo Otero J, Fontán Scheitler L. Enfermedad con cuerpos de Lewy. Rev. Méd. Urug. [Internet]. 30 de septiembre de 2008 [citado 27 de septiembre de 2022];24(3):195-02. Disponible en: http://revista.rmu.org.uy/ojsrmu311/index.php/rmu/article/view/572
Sección
Trabajos de Revisión o Actualización y Puestas al día