Depressive symptoms in neurodegenerative diseases

Table 4 Diagnostic criteria for Lewy bodies disease

Central feature

Progressive dementia-deficits in attention and executive function are typical

Prominent memory impairment may not be evident in the early stages

Core features

Fluctuating cognition with pronounced variations in attention and alertness

Recurrent complex visual hallucinations

Spontaneous features of parkinsonism

Suggestive features

REM sleep behavior disorder which can appear years before the onset of dementia and parkinsonism

Severe intensity to neuroleptics occurs in up to 50% of LBD patients who take them

Low dopamine transporter uptake in the brain’s basal ganglia as seen on SPECT an PET imaging scans

Supportive features

Repeated falls and syncope (fainting)

Transient, unexplained loss of consciousness

Autonomic dysfunction

Hallucinations of other modalities

Visuospatial abnormalities like depth perception, object orientation, directional sense and illusions

Other psychiatric disturbances like systematized delusions, aggression and depression

A probable LBD diagnosis require either

Dementia plus two or more core features, or

Dementia plus one core features and one or more suggestive features

LBD: Lewy body dementia; PET: Positron emission tomography; SPECT: Single photon emission computed tomography.