Abstract

REVIEW ON NAVIGATING THE ENIGMA: UNRAVELLING CHALLENGES IN EARLY DISCRIMINATORY DIAGNOSIS AND PREDICTING COGNITIVE DECLINE IN DEMENTIA WITH LEWY BODIES

Ezilkkavia S.*, Felic S., Dr. Raghul G. and Senthil M.

ABSTRACT

Background: Early and precise diagnosis of Dementia with Lewy Bodies (DLB) poses challenges due to the low sensitivity of clinical criteria and a lack of universally accepted biomarkers, complicating differentiation from Alzheimer's disease (AD). Despite being the second most prevalent form of neurodegenerative dementia, DLB is often under-recognized, impacting its prognosis. Methods: This comprehensive review focused on identifying biomarkers for DLB through a systematic literature search covering EEG, imaging, genetics, and CSF markers. Key findings highlighted scintigraphy of the striatal dopamine transporter system using FP-CIT SPECT, along with promising outcomes in cardiovascular autonomic function studies and innovative CSF techniques. Structural MRI, perfusion SPECT, genetics, and EEG studies illuminated group-level differences between DLB and AD. Results: Despite challenges, potential biomarkers,
especially the scintigraphy of the dopamine transporter system, exhibited promising diagnostic accuracy, supported by data from multicenter studies and autopsy-confirmed cases. The definition of research criteria for mild cognitive impairment in DLB offers potential for earlier diagnosis and structured follow-up. Ongoing exploration of proteomic techniques and innovative approaches holds exciting prospects for advancing diagnostic precision. Conclusion: This review underscores the significance of identified biomarkers, particularly dopamine transporter system scintigraphy, in addressing the complexities of DLB diagnosis. Continued research is essential to validate and integrate these markers into clinical practice, offering a more nuanced understanding and prediction of cognitive decline in DLB patients

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