DLB and PDD boundary issues: Diagnosis, treatment, molecular pathology, and biomarkers

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperReviewResearchpeer-review

  • C. F. Lippa, University of California, San Diego, Drexel University College of Medicine
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  • J. E. Duda, Philadelphia VA's Parkinson's Disease Research
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  • M. Grossman, The Pennsylvania State University
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  • H. I. Hurtig, University of Pennsylvania Health System
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  • D. Aarsland, Stavanger University Hospital, Stavanger, Universitetet i Bergen
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  • B. F. Boeve, Mayo Clinic
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  • D. J. Brooks
  • D. W. Dickson, Mayo Clinic in Jacksonville, Florida
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  • B. Dubois, Pitie-Salpetriere Hospital
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  • M. Emre, Department of Neurology
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  • S. Fahn, Neurological Institute
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  • J. M. Farmer, The Pennsylvania State University
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  • D. Galasko, University of California, San Diego
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  • J. E. Galvin, Washington University in St. Louis
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  • C. G. Goetz, Rush University Medical Center
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  • J. H. Growdon, Massachusetts General Hospital, Boston
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  • K. A. Gwinn-Hardy, NINDS-NIH
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  • J. Hardy, NINDS-NIH
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  • P. Heutink, VU University Medical Center
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  • T. Iwatsubo, University Tokyo
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  • K. Kosaka, Yokohama City University
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  • V. M.Y. Lee, The Pennsylvania State University
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  • J. B. Leverenz
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  • E. Masliah, Newcastle University, United Kingdom
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  • I. G. McKeith, Newcastle University
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  • R. L. Nussbaum, Genetic Disease Research Branch
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  • C. W. Olanow, Mount Sinai Medical Center
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  • B. M. Ravina, University of Rochester
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  • A. B. Singleton, National Institutes of Health
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  • C. M. Tanner, Mayo Clinic in Jacksonville, Florida
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  • J. Q. Trojanowski, The Pennsylvania State University
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  • Z. K. Wszolek, Drexel University College of Medicine

For more than a decade, researchers have refined criteria for the diagnosis of dementia with Lewy bodies (DLB) and at the same time have recognized that cognitive impairment and dementia occur commonly in patients with Parkinson disease (PD). This article addresses the relationship between DLB, PD, and PD with dementia (PDD). The authors agreed to endorse "Lewy body disorders" as the umbrella term for PD, PDD, and DLB, to promote the continued practical use of these three clinical terms, and to encourage efforts at drug discovery that target the mechanisms of neurodegeneration shared by these disorders of α-synuclein metabolism. We concluded that the differing temporal sequence of symptoms and clinical features of PDD and DLB justify distinguishing these disorders. However, a single Lewy body disorder model was deemed more useful for studying disease pathogenesis because abnormal neuronal α-synuclein inclusions are the defining pathologic process common to both PDD and DLB. There was consensus that improved understanding of the pathobiology of α-synuclein should be a major focus of efforts to develop new disease-modifying therapies for these disorders. The group agreed on four important priorities: 1) continued communication between experts who specialize in PDD or DLB; 2) initiation of prospective validation studies with autopsy confirmation of DLB and PDD; 3) development of practical biomarkers for α-synuclein pathologies; 4) accelerated efforts to find more effective treatments for these diseases.

Original languageEnglish
JournalNeurology
Volume68
Issue11
Pages (from-to)812-819
Number of pages8
ISSN0028-3878
DOIs
Publication statusPublished - 1 Mar 2007

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