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m Changed the early "autonomic nervous system" link to point to that article rather than "dysautonomia", since it's reasonable to the that the reader is looking for basic definitions of terms this early in the article. If the article also needs a link to "dysatonomia", then we should introduce that term somewhere in the body. |
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{{Short description|Umbrella term covering two types of dementia}}
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[[Parkinson's disease dementia]] (PDD).<ref name=Gomperts2016>{{cite journal |vauthors=Gomperts SN |title=Lewy Body Dementias: Dementia With Lewy Bodies and Parkinson Disease Dementia |journal=Continuum (Minneap Minn) |volume=22 |issue=2 Dementia |pages=435–63 |date=April 2016 |pmid=27042903 |pmc=5390937 |doi=10.1212/CON.0000000000000309}}</ref><ref name=Pezzoli2017>{{cite journal |vauthors=Pezzoli S, Cagnin A, Bandmann O, Venneri A |title=Structural and Functional Neuroimaging of Visual Hallucinations in Lewy Body Disease: A Systematic Literature Review |journal=Brain Sci |volume=7 |issue=12 |pages= 84|date=July 2017 |pmid=28714891 |pmc=5532597 |doi=10.3390/brainsci7070084 |doi-access=free }}</ref><ref name= Galasko2017>{{cite journal |vauthors=Galasko D |title=Lewy Body Disorders |journal=Neurol Clin |volume=35 |issue=2 |pages=325–38 |date=May 2017 |pmid=28410662 |pmc=5912679 |doi=10.1016/j.ncl.2017.01.004 }}</ref><ref name=Kon2020/> Both are characterized by changes in thinking, movement, behavior, and mood.<ref name=Walker2015/> The two conditions have similar features and may have similar causes, and are believed to belong on a spectrum of '''Lewy body disease'''<ref name=Gomperts2016/> that includes [[Parkinson's disease]].<ref name=Kon2020>{{cite journal |vauthors=Kon T, Tomiyama M, Wakabayashi K |title=Neuropathology of Lewy body disease: Clinicopathological crosstalk between typical and atypical cases |journal=Neuropathology |volume=40 |issue=1 |pages=30–39 |date=February 2020 |pmid=31498507 |doi=10.1111/neup.12597|s2cid=201983865 |doi-access=free }}</ref> As of 2014, they were more often misdiagnosed than any other common dementia.<ref name=Taylor2014/>
The exact cause is unknown,<!-- NINDS20202 --> but involves widespread deposits of abnormal clumps of protein that form in [[neuron]]s of the diseased brain.<!-- Walker2015 --> Known as [[Lewy body|Lewy bodies]] (discovered in 1912 by [[Frederic Lewy]]<ref name= NINDS2020Book/>) and [[Lewy neurite]]s, these clumps affect both the [[central nervous system]] and the [[
==Classification==
{{further|Dementia with Lewy bodies#Classification}}
The [[Synucleinopathy|synucleinopathies]] ([[dementia with Lewy bodies]], [[Parkinson's disease dementia]], and [[Parkinson's disease]]) are characterized by shared features of [[parkinsonism]] motor symptoms, neuropsychiatric symptoms, impaired cognition, [[sleep disorder]]s, and [[visual hallucination]]s.<ref name=Valayudhan2017>{{cite journal |vauthors=Velayudhan L, Ffytche D, Ballard C, Aarsland D |title=New Therapeutic Strategies for Lewy Body Dementias |journal=Curr Neurol Neurosci Rep |volume=17 |issue=9 |pages=68 |date=September 2017 |pmid=28741230 |doi=10.1007/s11910-017-0778-2 |s2cid=3739100 |type= Review}}</ref><ref name=McKeithConsensus2017>{{cite journal |vauthors=McKeith IG, Boeve BF, Dickson DW, ''et al'' |title=Diagnosis and management of dementia with Lewy bodies: Fourth consensus report of the DLB Consortium |journal=Neurology |volume=89 |issue=1 |pages=88–100 |date=July 2017 |pmid=28592453 |pmc=5496518 |doi=10.1212/WNL.0000000000004058 |type=Review }}</ref> The Lewy body
[[MeSH]] lists Lewy body disease in several categories: as a nervous system disease in two listings one as a basal ganglia Parkinsonian movement disorder and the other under brain disease as a dementia; as a neurodegenerative disorder listed as a synucleinopathy; and as a neurocognitive disorder listed with dementia.<ref name="MeSH">{{cite web |title=MeSH Browser |url=https://meshb.nlm.nih.gov/record/ui?ui=D020961 |website=meshb.nlm.nih.gov |access-date=17 November 2020}}</ref>
A genetic architecture that predisposes an individual to some disease [[phenotype]]s is found in Parkinson's disease and the Lewy body dementias. The presence of Lewy bodies is a link between these disorders; the term 'diseases with Lewy bodies' therefore may be more accurate than 'Lewy body disease'.<ref>{{cite journal |vauthors=Menšíková K, Matěj R, Colosimo C, et al |title=Lewy body disease or diseases with Lewy bodies? |journal=
==Cause and mechanisms==
{{Further|Dementia with Lewy bodies#Pathophysiology}}
Dementia with Lewy bodies and Parkinson's disease dementia are similar in many ways, suggesting there may be a common pathophysiological mechanism, with PDD and DLB at opposite ends of a Lewy body disease spectrum,<ref name=Gomperts2016/> and a shared component of protein deposits in [[Lewy body|Lewy bodies]] and [[Lewy neurite]]s.<ref name=Weil2017>{{cite journal |vauthors=Weil RS, Lashley TL, Bras J, Schrag AE, Schott JM |title=Current concepts and controversies in the pathogenesis of Parkinson's disease dementia and Dementia with Lewy Bodies |journal=F1000Res |volume=6 |pages=1604 |date=2017 |pmid=28928962 |pmc=5580419 |doi=10.12688/f1000research.11725.1 |type=Review |doi-access=free }}</ref> Lewy bodies and neurites have been found to develop from the aggregation of misfolded [[alpha-synuclein]], a protein thought to assist in neurotransmitter release and vesicle turnover; whether these [[misfolded protein]]s are responsible for the neurodegenerative effects remains unclear, and no definitive link between Lewy bodies and neurodegenerative effects has been found.<ref name=Latimer2018/> DSM-5 gives Lewy body disease as the causative subtype of DLB, and [[Parkinson's disease]] as the causative subtype of PDD.<ref name="DSM5">{{cite book |title=Diagnostic and statistical manual of mental disorders : DSM-5 |date=2013 |publisher=American Psychiatric Association |location=Arlington, VA |isbn=9780890425541 |pages=603–604 |edition=5th}}</ref> DLB is marked by the presence of Lewy bodies primarily in the [[Cerebral cortex|cortical regions]], and PDD with Lewy bodies primarily in the subcortical [[basal ganglia]].<ref name="DSM5A">{{cite book |title=Diagnostic and statistical manual of mental disorders : DSM-5. |date=2013 |publisher=American Psychiatric Association |location=Arlington, VA |isbn=9780890425541 |page=619 |edition=5th}}</ref>
Despite differences in the timing of the appearance of symptoms, the two dementias "show remarkably convergent neuropathological changes at autopsy".<ref name=Gomperts2016/> The relationship between Parkinson's disease dementia and dementia with Lewy bodies is unclear as of 2020, but there is likely to be genetic overlap, and the two conditions may represent different points on a continuum.<ref name=Taylor2020>{{cite journal |vauthors=Taylor JP, McKeith IG, Burn DJ, et al |title=New evidence on the management of Lewy body dementia |journal=Lancet Neurol |volume=19 |issue=2 |pages=157–69 |date=February 2020 |pmid=31519472 |doi=10.1016/S1474-4422(19)30153-X |pmc=7017451 |type= Review|hdl=10871/36535 |hdl-access=free |url= https://ore.exeter.ac.uk/repository/bitstream/handle/10871/36535/Management%20Lewy%20body%20dementia_versionsubmittedtoTLNwithappendix.pdf?sequence=10&isAllowed=y<!-- citation consistency, link to free full text in title-->}}</ref>
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==Epidemiology==
{{further|Dementia with Lewy bodies#Epidemiology}}
Between 5% and 25% of diagnosed dementias in older adults are due to one of the Lewy body dementias.<ref name= Connors2018/>{{efn| Kosaka (2017) writes: "Dementia with Lewy bodies (DLB) is now well known to be the second most frequent dementia following Alzheimer disease (AD). Of all types of dementia, AD is known to account for about 50%, DLB about 20% and vascular dementia (VD) about 15%. Thus, AD, DLB, and VD are now considered to be the three major dementias."<ref>{{cite book|veditors= Kosaka K |editor-link= Kenji Kosaka (psychiatrist)|date=2017 |title= Dementia with Lewy bodies: clinical and biological aspects|edition= 1st |publisher= Springer: Japan |doi= 10.1007/978-4-431-55948-1 |isbn= 978-4-431-55948-1|s2cid= 45950966}}</ref><!-- Page v --> The NINDS (2020) says that Lewy body dementia "is one of the most common causes of dementia, after
LBD usually develops after the age of 50.<ref name= NINDS2020Book/> Men are more likely to be diagnosed than women.<ref name= NINDS2020Book/>
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[[File:Robin Williams 2011a.jpg|thumb|right|upright=0.9|Robin Williams (shown in 2011): his widow said he was diagnosed on autopsy with Lewy bodies.<ref name=RobinWidow/><ref name=Williams2016/>]]
[[Robin Williams]], the American actor and comedian, died on August 11, 2014. Before his suicide, he had been diagnosed with Parkinson's disease,<ref name=RobinWidow>{{Cite news|author= Gallman S |title = Robin Williams' widow speaks: Depression didn't kill my husband |url = http://www.cnn.com/2015/11/03/health/robin-williams-widow-susan-williams/index.html|work = CNN|access-date = April 6, 2018 |url-status=live|archive-url = https://web.archive.org/web/20151104002632/http://www.cnn.com/2015/11/03/health/robin-williams-widow-susan-williams/index.html|archive-date = November 4, 2015 |date= November 4, 2015}}</ref> and according to his widow, Susan Schneider Williams, he experienced depression, [[anxiety]], and increasing [[paranoia]].<ref name=Williams2016>{{cite journal |vauthors=Williams SS |title=The terrorist inside my husband's brain |journal=Neurology |volume=87 |issue=13 |pages=1308–11 |date=September 2016 |pmid=27672165 |doi=10.1212/WNL.0000000000003162 |doi-access=free }}</ref> Upon autopsy, his widow said he was found to have diffuse Lewy body disease,<ref name=RobinWidow/><ref name=Williams2016/><ref name=HowLewy>{{cite news |url= https://www.scientificamerican.com/article/how-lewy-body-dementia-gripped-robin-williams1/ |title= How Lewy body dementia gripped Robin Williams |author= Robbins R |work= Scientific American |date= September 30, 2016 |access-date= April 9, 2018}}</ref> while the autopsy used the term ''diffuse Lewy body dementia''.<ref name=LBDA/> The vocabulary associated with Lewy pathology causes confusion.<ref name= Armstrong2021/> ''Lewy body dementia'' (the umbrella term that encompasses the clinical diagnoses of dementia with Lewy bodies and Parkinson's disease dementia) differs from ''Lewy body disease'' (the term used to describe pathological findings of Lewy bodies on autopsy).<ref name= Armstrong2021>{{cite journal |vauthors=Armstrong MJ |title=Advances in dementia with Lewy bodies |journal=Ther Adv Neurol Disord |volume=14 |issue= |pages=17562864211057666 |date=2021 |pmid=34840608 |pmc=8613883 |doi=10.1177/17562864211057666 |type=Review}}</ref> Dennis Dickson, a spokesperson for the Lewy Body Dementia Association, clarified the distinction by stating that ''diffuse Lewy body dementia'' is more commonly called ''diffuse Lewy body disease'' and refers to the underlying disease process.<ref name=LBDA>{{cite web |url=https://www.lbda.org/content/lbda-clarifies-autopsy-report-comedian-robin-williams |publisher= [[Lewy Body Dementia Association]] |title= LBDA Clarifies Autopsy Report on Comedian, Robin Williams |date= November 10, 2014 | access-date = April 19, 2018 |archive-url= https://web.archive.org/web/20200812093153/https://www.lbda.org/content/lbda-clarifies-autopsy-report-comedian-robin-williams |archive-date= August 12, 2020}}</ref> According to Dickson, "Lewy bodies are generally limited in distribution" in early Parkinson's disease, while in [[dementia with Lewy bodies]], "the Lewy bodies are spread widely throughout the brain, as was the case with Robin Williams."<ref name=LBDA/> [[Ian G. McKeith]], professor and researcher of Lewy body dementias, commented that Williams' symptoms and autopsy findings were explained by dementia with Lewy bodies.<ref>{{Cite news |url= https://theconversation.com/robin-williams-had-dementia-with-lewy-bodies-so-what-is-it-and-why-has-it-been-eclipsed-by-alzheimers-50221 |title= Robin Williams had dementia with Lewy bodies – so, what is it and why has it been eclipsed by Alzheimer's? | author = McKeith IG | newspaper= The Conversation |access-date= April 6, 2018 |url-status=live|archive-url=https://web.archive.org/web/20161104010452/https://theconversation.com/robin-williams-had-dementia-with-lewy-bodies-so-what-is-it-and-why-has-it-been-eclipsed-by-alzheimers-50221 |archive-date= November 4, 2016 }}</ref>
The British author and poet [[Mervyn Peake]] died in 1968 and was diagnosed [[Retrospective diagnosis|posthumously]] as a probable case of DLB in a 2003 paper published in ''[[JAMA Neurology]]''.<ref name=Sahlas2003>{{cite journal |vauthors=Sahlas DJ |title=Dementia with Lewy bodies and the neurobehavioral decline of Mervyn Peake |journal=Arch. Neurol. |volume=60 |issue=6 |pages=889–92 |date=June 2003 |pmid=12810496 |doi=10.1001/archneur.60.6.889 |doi-access=free }}</ref> Sahlas said his death was "variously ascribed to Alzheimer disease, Parkinson disease, or postencephalitic parkinsonism".<ref name=Sahlas2003/> Based on signs in his work and letters of progressive deterioration, fluctuating cognitive decline, deterioration in visuospatial function, declining [[attention span]], and visual hallucinations and delusions, his may be the earliest known case where DLB was found to have been the likely cause of death.<ref name=Sahlas2003/>
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Other entertainers and artists who have or died from LBD include [[Estelle Getty]], the actress known for her role as Sophia on the television series ''[[The Golden Girls]]'',<ref name=guardian-obit>{{cite news |author=Carlson M |title=Obituary: Estelle Getty |url=https://www.theguardian.com/culture/2008/jul/24/television.television |access-date=October 13, 2013 |newspaper=[[theguardian.com]] |date=July 24, 2008 |url-status=live |archive-url=https://web.archive.org/web/20130902115947/http://www.theguardian.com/culture/2008/jul/24/television.television |archive-date=September 2, 2013}}</ref> [[Nicholas King]], a US actor and horticulturist,<ref>{{cite news | url= http://www.latimes.com/news/obituaries/la-me-nicholas-king-20120423,0,3790852.story |author= McLellan D |date= April 23, 2012 |title= Nicholas King dies at 79; actor helped preserve the Watts Towers |work= The Los Angeles Times |access-date= April 19, 2018}}</ref> actress [[Dina Merrill]],<ref>{{cite news |url=https://www.townandcountrymag.com/society/a9914626/dina-merrill-obituary/ |title=Actress and philanthropist Dina Merrill dies at 93 |access-date=March 22, 2018 |work= Town and Country Magazine |date= May 23, 2017 |author= Dangremond S }}</ref> [[Donald Featherstone (artist)|Donald Featherstone]], who created the plastic pink flamingo,<ref>{{Cite news | url=http://www.latimes.com/local/obituaries/la-me-0624-donald-featherstone-20150624-story.html | title= Don Featherstone dies at 79; creator of the plastic pink flamingo |author= Woo E |date= June 24, 2015 | access-date= March 22, 2018 |work= Los Angeles Times}}</ref> American radio and television host [[Casey Kasem]],<ref>{{cite news |url=https://www.cnn.com/2014/06/20/health/casey-kasem-end-of-life-care/index.html | title= Casey Kasem and a lesson about end-of-life care |author= Caffrey J |publisher= CNN |date= April 18, 2016 | access-date= March 22, 2018}}</ref> Canadian singer [[Pierre Lalonde]],<ref>{{cite news|author = Papineau P |url=https://www.ledevoir.com/culture/actualites-culturelles/474105/deces-de-pierre-lalonde| title = L'idole d'une génération s'éteint|publisher=[[Le Devoir]]|date=June 23, 2016|access-date=April 9, 2018 |language= fr}}</ref><ref>{{cite web|url=http://www.journaldemontreal.com/2016/06/22/pierre-lalonde-souffrait-aussi-de-la-demence-de-corps-de-lewy/|title=Pierre Lalonde souffrait aussi de la démence à corps de Lewy|publisher= Le Journal de Montréal|access-date=March 22, 2018 |author= Belanger C |language= fr |date= June 22, 2016}}</ref> graphic artist/film set designer [[Ron Cobb]],<ref>{{cite news |vauthors=Bartlett R, Parker R |title=Ron Cobb, designer of the 'Alien' Ship and the 'Back to the Future' DeLorean, dies at 83 |url=https://www.hollywoodreporter.com/news/ron-cobb-dead-designer-alien-ship-back-future-delorean-was-83-1149219 |work=www.hollywoodreporter.com |date=September 21, 2020 |access-date= September 26, 2020}}</ref> American actor [[Frank Bonner]],<ref>{{Cite web|url=https://www.thewrap.com/frank-bonner-wkrp-in-cincinnati-star-dies-at-79/|title=Frank Bonner, 'WKRP in Cincinnati' Star, Dies at 79|first1=Tony|last1=Reid|first2=Maglio|last2=Nakamura|work=[[TheWrap]]|date=June 17, 2021|access-date=June 17, 2021}}</ref> and Canadian musician and actor [[André Gagnon]].<ref>{{cite web |url=https://montreal.ctvnews.ca/pianist-and-composer-andre-gagnon-dead-at-84-remembered-as-musical-jack-of-all-trades-1.5216668|title=Pianist and composer Andre Gagnon, dead at 84, remembered as musical 'jack of all trades'|date=December 3, 2020|accessdate= November 9, 2021|website=CTV News}}</ref>
Individuals from industry or government who have or died from LBD
a US [[Democratic Party (United States)|Democratic]] politician of the [[Illinois Senate]],<ref>{{cite news |url= http://chicago.suntimes.com/news/7/71/1288547/philip-rock-longest-serving-illinois-senate-president-dies |title= Philip Rock, ex-Senate leader known for mentoring and bipartisanship, dies |work= [[Chicago Sun-Times]] |date= January 29, 2016 |access-date= April 19, 2018 | url-status=dead |archive-url=https://web.archive.org/web/20160201093023/http://chicago.suntimes.com/news/7/71/1288547/philip-rock-longest-serving-illinois-senate-president-dies |archive-date= February 1, 2016 }}</ref>
[[Arnold R. Hirsch]], an American historian who taught at the [[University of New Orleans]],<ref>{{cite news |author= O'Donnell M |title= Arnold R. Hirsch dies; analyzed Chicago segregation in influential book |url= https://chicago.suntimes.com/news/arnold-r-hirsch-dies-analyzed-chicago-segregation-in-influential-book/ |access-date= April 19, 2018 |work= Chicago Sun Times |date= March 26, 2018}}</ref> and [[Jessie Isabelle Price]], an American veterinary [[microbiologist]],<ref>{{cite news |title= Jessie Isabelle Price Dies On November 12 |url= http://www.27east.com/news/article.cfm/Quogue/131382/Jessie-Isabelle-Price-Dies-On-November-12 |access-date= April 19, 2018 |work= The Southampton Press |date= November 23, 2015}}</ref> died from LBD.
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''[[Sleepwalk with Me]]'' is a book, one-man comedy, and film about a young man with relationship problems and [[REM sleep behavior disorder|RBD]], a precursor to [[synucleinopathy]], including LBD.<ref>{{cite web |url= http://www.sleepeducation.org/news/2012/01/27/sleepwalk-with-me-comedian's-sleep-disorder-experience-comes-to-film |title= Sleepwalk with Me: Comedian's sleep disorder experience comes to film |publisher= American Academy of Sleep Medicine | date= January 26, 2012 |access-date= April 22, 2018}}</ref>
== Notes ==
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{{Medical resources
| DiseasesDB =
| ICD11 = {{ICD11|6D82}}, {{ICD11|6D85.0}}
| ICD10 = {{ICD10|G31.8}}† {{ICD10|F02.8}}*
| ICD9 =
| |||