Case Report: The Role of Neuropsychological Assessment and Imaging Biomarkers in the Early Diagnosis of Lewy Body Dementia in a Patient With Major Depression and Prolonged Alcohol and Benzodiazepine Dependence
Dementia with Lewy bodies (DLB) is the second most common form of dementia and is assumed to be often under- or misdiagnosed, especially in early stages. Here we present a complex case of probable DLB with major depression and alcohol and benzodiazepine dependence in which DLB was ruled out initiall...
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| Format: | Article |
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Frontiers Media S.A.
2020-07-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fpsyt.2020.00684/full |
| _version_ | 1818278783880265728 |
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| author | Caroline Bouter Niels Hansen Charles Timäus Jens Wiltfang Jens Wiltfang Jens Wiltfang Claudia Lange |
| author_facet | Caroline Bouter Niels Hansen Charles Timäus Jens Wiltfang Jens Wiltfang Jens Wiltfang Claudia Lange |
| author_sort | Caroline Bouter |
| collection | DOAJ |
| description | Dementia with Lewy bodies (DLB) is the second most common form of dementia and is assumed to be often under- or misdiagnosed, especially in early stages. Here we present a complex case of probable DLB with major depression and alcohol and benzodiazepine dependence in which DLB was ruled out initially. This case highlights the challenging diagnostic workup of DLB patients. Core clinical features can be missing and indicative biomarkers can be negative, especially in early stages of the disease. Initially, Fluorodeoxyglucose positron emission tomography as well as neuropsychological assessment were suspicious for a possible DLB diagnosis in our patient while core clinical criteria were missing and the indicative biomarker 123I-FP-CIT SPECT was negative. Follow up was performed two years later and the patients showed several core and supportive clinical features of DLB and 123I-FP-CIT SPECT showed a pathological pattern. Extensive neuropsychological assessment in combination with PET imaging might provide crucial evidence for DLB even in early stages. If neuropsychology and PET imaging point to an early DLB diagnosis careful follow-up should be performed as core symptoms and indicative biomarkers might appear in later stages of the disease. |
| first_indexed | 2024-12-12T23:22:56Z |
| format | Article |
| id | doaj.art-337f5c4f0e9c455f87adf1658745a8e3 |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-12-12T23:22:56Z |
| publishDate | 2020-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj.art-337f5c4f0e9c455f87adf1658745a8e32022-12-22T00:08:13ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402020-07-011110.3389/fpsyt.2020.00684538966Case Report: The Role of Neuropsychological Assessment and Imaging Biomarkers in the Early Diagnosis of Lewy Body Dementia in a Patient With Major Depression and Prolonged Alcohol and Benzodiazepine DependenceCaroline Bouter0Niels Hansen1Charles Timäus2Jens Wiltfang3Jens Wiltfang4Jens Wiltfang5Claudia Lange6Department of Nuclear Medicine, University Medical Center Göttingen (UMG), Georg-August-University, Goettingen, GermanyDepartment of Psychiatry and Psychotherapy, University Medical Center Göttingen (UMG), Georg-August-University, Goettingen, GermanyDepartment of Psychiatry and Psychotherapy, University Medical Center Göttingen (UMG), Georg-August-University, Goettingen, GermanyDepartment of Psychiatry and Psychotherapy, University Medical Center Göttingen (UMG), Georg-August-University, Goettingen, GermanyGerman Center for Neurodegenerative Diseases (DZNE), Goettingen, GermanyNeurosciences and Signaling Group, Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro, PortugalDepartment of Psychiatry and Psychotherapy, University Medical Center Göttingen (UMG), Georg-August-University, Goettingen, GermanyDementia with Lewy bodies (DLB) is the second most common form of dementia and is assumed to be often under- or misdiagnosed, especially in early stages. Here we present a complex case of probable DLB with major depression and alcohol and benzodiazepine dependence in which DLB was ruled out initially. This case highlights the challenging diagnostic workup of DLB patients. Core clinical features can be missing and indicative biomarkers can be negative, especially in early stages of the disease. Initially, Fluorodeoxyglucose positron emission tomography as well as neuropsychological assessment were suspicious for a possible DLB diagnosis in our patient while core clinical criteria were missing and the indicative biomarker 123I-FP-CIT SPECT was negative. Follow up was performed two years later and the patients showed several core and supportive clinical features of DLB and 123I-FP-CIT SPECT showed a pathological pattern. Extensive neuropsychological assessment in combination with PET imaging might provide crucial evidence for DLB even in early stages. If neuropsychology and PET imaging point to an early DLB diagnosis careful follow-up should be performed as core symptoms and indicative biomarkers might appear in later stages of the disease.https://www.frontiersin.org/article/10.3389/fpsyt.2020.00684/fulldementia with Lewy bodies123I-FP-CIT18F-FDG-PETdementiabiomarker |
| spellingShingle | Caroline Bouter Niels Hansen Charles Timäus Jens Wiltfang Jens Wiltfang Jens Wiltfang Claudia Lange Case Report: The Role of Neuropsychological Assessment and Imaging Biomarkers in the Early Diagnosis of Lewy Body Dementia in a Patient With Major Depression and Prolonged Alcohol and Benzodiazepine Dependence Frontiers in Psychiatry dementia with Lewy bodies 123I-FP-CIT 18F-FDG-PET dementia biomarker |
| title | Case Report: The Role of Neuropsychological Assessment and Imaging Biomarkers in the Early Diagnosis of Lewy Body Dementia in a Patient With Major Depression and Prolonged Alcohol and Benzodiazepine Dependence |
| title_full | Case Report: The Role of Neuropsychological Assessment and Imaging Biomarkers in the Early Diagnosis of Lewy Body Dementia in a Patient With Major Depression and Prolonged Alcohol and Benzodiazepine Dependence |
| title_fullStr | Case Report: The Role of Neuropsychological Assessment and Imaging Biomarkers in the Early Diagnosis of Lewy Body Dementia in a Patient With Major Depression and Prolonged Alcohol and Benzodiazepine Dependence |
| title_full_unstemmed | Case Report: The Role of Neuropsychological Assessment and Imaging Biomarkers in the Early Diagnosis of Lewy Body Dementia in a Patient With Major Depression and Prolonged Alcohol and Benzodiazepine Dependence |
| title_short | Case Report: The Role of Neuropsychological Assessment and Imaging Biomarkers in the Early Diagnosis of Lewy Body Dementia in a Patient With Major Depression and Prolonged Alcohol and Benzodiazepine Dependence |
| title_sort | case report the role of neuropsychological assessment and imaging biomarkers in the early diagnosis of lewy body dementia in a patient with major depression and prolonged alcohol and benzodiazepine dependence |
| topic | dementia with Lewy bodies 123I-FP-CIT 18F-FDG-PET dementia biomarker |
| url | https://www.frontiersin.org/article/10.3389/fpsyt.2020.00684/full |
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