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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 875-882 |
| Number of pages | 8 |
| Journal | Neurology |
| Volume | 77 |
| Issue number | 9 |
| DOIs | |
| State | Published - Aug 30 2011 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Clinical Neurology
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Inclusion of RBD improves the diagnostic classification of dementia with Lewy bodies. / Ferman, T. J.; Boeve, B. F.; Smith, G. E.; Lin, S. C.; Silber, M. H.; Pedraza, O.; Wszolek, Z.; Graff-Radford, N. R.; Uitti, R.; Van Gerpen, J.; Pao, W.; Knopman, D.; Pankratz, V. S.; Kantarci, K.; Boot, B.; Parisi, J. E.; Dugger, Brittany; Fujishiro, H.; Petersen, R. C.; Dickson, D. W.
In: Neurology, Vol. 77, No. 9, 30.08.2011, p. 875-882.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Inclusion of RBD improves the diagnostic classification of dementia with Lewy bodies
AU - Ferman, T. J.
AU - Boeve, B. F.
AU - Smith, G. E.
AU - Lin, S. C.
AU - Silber, M. H.
AU - Pedraza, O.
AU - Wszolek, Z.
AU - Graff-Radford, N. R.
AU - Uitti, R.
AU - Van Gerpen, J.
AU - Pao, W.
AU - Knopman, D.
AU - Pankratz, V. S.
AU - Kantarci, K.
AU - Boot, B.
AU - Parisi, J. E.
AU - Dugger, Brittany
AU - Fujishiro, H.
AU - Petersen, R. C.
AU - Dickson, D. W.
PY - 2011/8/30
Y1 - 2011/8/30
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=80055077766&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=80055077766&partnerID=8YFLogxK
U2 - 10.1212/WNL.0b013e31822c9148
DO - 10.1212/WNL.0b013e31822c9148
M3 - Article
C2 - 21849645
AN - SCOPUS:80055077766
VL - 77
SP - 875
EP - 882
JO - Neurology
JF - Neurology
SN - 0028-3878
IS - 9
ER -