@article{491a9a3d088f49a68e59b78d41f29280,
title = "Inclusion of RBD improves the diagnostic classification of dementia with Lewy bodies",
abstract = "Objective: To determine whether adding REM sleep behavior disorder (RBD) to the dementia with Lewy bodies (DLB) diagnostic criteria improves classification accuracy of autopsy-confirmed DLB. Methods: We followed 234 consecutive patients with dementia until autopsy with a mean of 4 annual visits. Clinical diagnoses included DLB, Alzheimer disease (AD), corticobasal syndrome, and frontotemporal dementia. Pathologic diagnoses used the 2005 DLB consensus criteria and included no/low likelihood DLB (non-DLB; n=136) and intermediate/high likelihood DLB (DLB; n= 98). Regression modeling and sensitivity/specificity analyses were used to evaluate the diagnostic role of RBD. Results: Each of the 3 core features increased the odds of autopsy-confirmed DLB up to 2-fold, and RBD increased the odds by 6-fold. When clinically probable DLB reflected dementia and 2 or more of the 3 core features, sensitivity was 85%, and specificity was 73%. When RBD was added and clinically probable DLB reflected 2 or more of 4 features, sensitivity improved to 88%. When dementia and RBD were also designated as probable DLB, sensitivity increased to 90% while specificity remained at 73%. The VH, parkinsonism, RBD model lowered sensitivity to 83%, but improved specificity to 85%. Conclusions: Inclusion of RBD as a core clinical feature improves the diagnostic accuracy of autopsy-confirmed DLB.",
author = "Ferman, {T. J.} and Boeve, {B. F.} and Smith, {G. E.} and Lin, {S. C.} and Silber, {M. H.} and O. Pedraza and Z. Wszolek and Graff-Radford, {N. R.} and R. Uitti and {Van Gerpen}, J. and W. Pao and D. Knopman and Pankratz, {V. S.} and K. Kantarci and B. Boot and Parisi, {J. E.} and Dugger, {B. N.} and H. Fujishiro and Petersen, {R. C.} and Dickson, {D. W.}",
note = "Funding Information: Study funding: Supported by NIH R01AG15866, P50AG16574, U01AG06786, P50NS072187 , and The Mangurian Foundation for Lewy Body Dementia Research. Funding Information: Dr. Ferman reports no disclosures. Dr. Boeve receives royalties from the publication of Behavioral Neurology of Dementia (Cambridge University Press, 2009); has served as a consultant for GE Healthcare; and receives research support from Cephalon, Inc., Allon Therapeutics, Inc., the NIH/NIA, the Alzheimer's Association, and the Mangurian Foundation. Dr. Smith serves on the editorial boards of The Clinical Neuropsychologist and the Journal of International Neuropsychological Society; serves as a consultant for Homeinstead Senior Living Inc.; and receives research support from the NIH (NCRR, NIA, NINDS) and Mayo Clinic Alzheimer's Disease Research Center. Dr. Lin reports no disclosures. Dr. Silber serves as Deputy Editor of Sleep and on the editorial board of the Journal of Clinical Sleep Medicine; receives publishing royalties for Sleep Medicine in Clinical Practice, 2nd edition (Informa Healthcare, 2010) and Atlas of Sleep Medicine (Informa Healthcare, 2010); and has received speaker honoraria from the American Academy of Neurology and the American Academy of Sleep Medicine. Dr. Pedraza receives research support from the NIH. Dr. Wszolek serves as Co-Editor-in-Chief of Parkinsonism and Related Disorders, Regional Editor of the European Journal of Neurology, and on the editorial boards of Neurologia i Neurochirurgia Polska, Advances in Rehabilitation, the Medical Journal of the Rzeszow University, and Clinical and Experimental Medical Letters; holds and has contractual rights for receipt of future royalty payments from patents re: A novel polynucleotide involved in heritable Parkinson's disease; receives royalties from publishing Parkinsonism and Related Disorders (Elsevier, 2007, 2008, 2009) and the European Journal of Neurology (Wiley-Blackwell, 2007, 2008, 2009); and receives research support from Allergan, Inc., the NIH, the Pacific Alzheimer Research Foundation (Canada), the CIHR, the Mayo Clinic Florida Research Committee CR program, and a gift from Carl Edward Bolch, Jr., and Susan Bass Bolch. Dr. Graff-Radford serves on a scientific advisory board for Codman; serves on the editorial boards of The Neurologist and Alzheimer Disease and Therapy; has received publishing royalties from UpToDate, Inc.; and receives research support from Pfizer Inc, Janssen, Forest Laboratories, Inc., Medivation, Inc., Allon Therapeutics, Inc., and the NIH/NIA. Dr. Uitti serves as an Associate Editor of Neurology{\textregistered}; has received research support from Advanced Neuromodulations Systems and from the NIH; and his institution receives annual royalties from Lundbeck Inc. from the licensing of the technology related to PARK8/LRRK2. Dr. Van Gerpen and Dr. Pao report no disclosures. Dr. Knopman serves as Deputy Editor for Neurology; has served on a data safety monitoring board for Eli Lilly and Company; has served as a consultant for Elan/Janssen AI; is an investigator in clinical trials sponsored by Elan/Janssen AI, Baxter International Inc., and Forest Laboratories, Inc.; and receives research support from the NIH. Dr. Pankratz receives research support from the NIH/NIA. Dr. Kantarci receives research support from the NIH. Dr. Boot reports no disclosures. Dr. Parisi serves on scientific advisory boards for the US Government Defense Health Board and the Subcommittee for Laboratory Services and Pathology; serves as a Section Editor for Neurology; receives royalties from the publication of Principles & Practice of Neuropathology, 2nd ed. (Oxford University Press, 2003); and receives research support from the NIH. B.N. Dugger and Dr. Fujishiro report no disclosures. Dr. Petersen serves on scientific advisory boards for the Alzheimer's Association, the National Advisory Council on Aging (NIA), Elan/Janssen AI, Pfizer Inc (Wyeth), and GE Healthcare; receives royalties from publishing Mild Cognitive Impairment (Oxford University Press, 2003); serves as a consultant for Elan/Janssen AI and GE Healthcare; and receives research support from the NIH/NIA. Dr. Dickson serves on the editorial boards of the American Journal of Pathology, Journal of Neuropathology and Experimental Neurology, Brain Pathology, Neurobiology of Aging, Journal of Neurology Neurosurgery and Psychiatry, Annals of Neurology, and Neuropathology; and receives research support from the NIH and Cure PSP/Society for PSP. ",
year = "2011",
month = aug,
day = "30",
doi = "10.1212/WNL.0b013e31822c9148",
language = "English (US)",
volume = "77",
pages = "875--882",
journal = "Neurology",
issn = "0028-3878",
publisher = "Lippincott Williams and Wilkins",
number = "9",
}