Hippocampal volume predicts dementia with Lewy bodies likelihood
medwireNews: Preserved hippocampal volume could distinguish which patients with mild cognitive impairment (MCI) are likely to develop dementia with Lewy bodies rather than Alzheimer’s disease (AD), researchers report.
“Being able to identify people who are at risk for dementia with Lewy bodies is important so they can receive the correct treatments early on,” said lead author Kejal Kantarci (Mayo Clinic, Rochester, Minnesota, USA) in a press statement.
“Early diagnosis also helps doctors know what drugs to avoid – up to 50% of people with dementia with Lewy bodies have severe reactions to antipsychotic drugs.”
Of 160 patients with MCI, 20 (13%) progressed to probable dementia with Lewy bodies and most (85%) of these individuals had normal hippocampal volumes (adjusted for total intracranial volume) on magnetic resonance imaging. By contrast, most (61%) of the 61 (38%) patients who progressed to AD dementia had hippocampal atrophy.
Indeed, the participants who did not have hippocampal atrophy were 5.8 times more likely to develop probable dementia with Lewy bodies than AD.
The association between preserved hippocampal volume and probable dementia with Lewy bodies was evident irrespective of MCI subtype, but it was particularly strong among those with MCI with nonamnestic features.
Patients with normal hippocampal volumes relative to those with hippocampal atrophy were 4.22 times more likely to progress to probable dementia with Lewy bodies, after taking into account age and including the MCI subtype, the researchers report in Neurology.
“Therefore both nonamnestic features and hippocampal preservation may be considered for identifying patients with MCI at risk for probable [dementia with Lewy bodies],” says the team.
“Better response to cholinesterase inhibitors and neuroleptic sensitivity may need to be addressed in patients with MCI who are likely to progress to probable [dementia with Lewy bodies].”
By Lucy Piper
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