Dementia with Lewy bodies : Impact of co-pathologies and implications for clinical trial design

© 2022 the Alzheimer's Association..

Dementia with Lewy bodies (DLB) is clinically defined by the presence of visual hallucinations, fluctuations, rapid eye movement (REM) sleep behavioral disorder, and parkinsonism. Neuropathologically, it is characterized by the presence of Lewy pathology. However, neuropathological studies have demonstrated the high prevalence of coexistent Alzheimer's disease, TAR DNA-binding protein 43 (TDP-43), and cerebrovascular pathologic cases. Due to their high prevalence and clinical impact on DLB individuals, clinical trials should account for these co-pathologies in their design and selection and the interpretation of biomarkers values and outcomes. Here we discuss the frequency of the different co-pathologies in DLB and their cross-sectional and longitudinal clinical impact. We then evaluate the utility and possible applications of disease-specific and disease-nonspecific biomarkers and how co-pathologies can impact these biomarkers. We propose a framework for integrating multi-modal biomarker fingerprints and step-wise selection and assessment of DLB individuals for clinical trials, monitoring target engagement, and interpreting outcomes in the setting of co-pathologies.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:19

Enthalten in:

Alzheimer's & dementia : the journal of the Alzheimer's Association - 19(2023), 1 vom: 01. Jan., Seite 318-332

Sprache:

Englisch

Beteiligte Personen:

Toledo, Jon B [VerfasserIn]
Abdelnour, Carla [VerfasserIn]
Weil, Rimona S [VerfasserIn]
Ferreira, Daniel [VerfasserIn]
Rodriguez-Porcel, Federico [VerfasserIn]
Pilotto, Andrea [VerfasserIn]
Wyman-Chick, Kathryn A [VerfasserIn]
Grothe, Michel J [VerfasserIn]
Kane, Joseph P M [VerfasserIn]
Taylor, Angela [VerfasserIn]
Rongve, Arvid [VerfasserIn]
Scholz, Sonja [VerfasserIn]
Leverenz, James B [VerfasserIn]
Boeve, Bradley F [VerfasserIn]
Aarsland, Dag [VerfasserIn]
McKeith, Ian G [VerfasserIn]
Lewis, Simon [VerfasserIn]
Leroi, Iracema [VerfasserIn]
Taylor, John P [VerfasserIn]
ISTAART Lewy body dementias Trial Methods Working Group [VerfasserIn]

Links:

Volltext

Themen:

α-synuclein
Biomarkers
Cerebrospinal fluid
Clinical trials
DNA-Binding Proteins
Dementia
Dementia with Lewy bodies
Journal Article
Lewy body dementia
MRI neurodegeneration
PET
Parkinsonism
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Review
TARDBP protein, human

Anmerkungen:

Date Completed 14.02.2023

Date Revised 02.01.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1002/alz.12814

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM347549578