Lewy Body Dementias: Dementia With Lewy Bodies and Parkinson Disease Dementia

Topic: Brain imaging, connectivity and assessment

Purpose of review This article provides an overview of the clinical features, neuropathologic findings, diagnostic criteria, and management of dementia with Lewy bodies (DLB) and Parkinson disease dementia (PDD), together known as the Lewy body dementias. Recent findings DLB and PDD are common, clinically similar syndromes that share characteristic neuropathologic changes, including deposition of α-synuclein in Lewy bodies and neurites and loss of tegmental dopamine cell populations and basal forebrain cholinergic populations, often with a variable degree of coexisting Alzheimer pathology. The clinical constellations of DLB and PDD include progressive cognitive impairment associated with parkinsonism, visual hallucinations, and fluctuations of attention and wakefulness. Current clinical diagnostic criteria emphasize these features and also weigh evidence for dopamine cell loss measured with single-photon emission computed tomography (SPECT) imaging and for rapid eye movement (REM) sleep behavior disorder, a risk factor for the synucleinopathies. The timing of dementia relative to parkinsonism is the major clinical distinction between DLB and PDD, with dementia arising in the setting of well-established idiopathic Parkinson disease (after at least 1 year of motor symptoms) denoting PDD, while earlier cognitive impairment relative to parkinsonism denotes DLB. The distinction between these syndromes continues to be an active research question. Treatment for these illnesses remains symptomatic and relies on both pharmacologic and nonpharmacologic strategies. Summary DLB and PDD are important and common dementia syndromes that overlap in their clinical features, neuropathology, and management. They are believed to exist on a spectrum of Lewy body disease, and some controversy persists in their differentiation. Given the need to optimize cognition, extrapyramidal function, and psychiatric health, management can be complex and should be systematic.

Key findings

• The clinical constellations of DLB and PDD include progressive cognitive impairment associated with parkinsonism, visual hallucinations, and fluctuations of attention and wakefulness.

New to this subject? Start with our plain-English guide: Brain scans & tests →

Study details

• Evidence strengthLow

Read the original

• DOI: 10.1212/con.0000000000000309
• PubMed: 27042903
• Original source →

Free copy unknown: no free-copy check has an answer for this record yet. That does not mean it is paywalled.

@article{gomperts2016-27042903,
  author  = {Gomperts, S. N.},
  title   = {{Lewy Body Dementias: Dementia With Lewy Bodies and Parkinson Disease Dementia}},
  journal = {Continuum (Minneapolis, Minn.)},
  year    = {2016},
  doi     = {10.1212/con.0000000000000309},
  pmid    = {27042903},
  url     = {https://doi.org/10.1212/con.0000000000000309}
}

Related studies in Brain scans and imaging

• Prodromal autonomic symptoms and signs in Parkinson's disease and dementia with Lewy bodies Movement disorders : official journal of the Movement Disorder Society · 2013-03-28 · usefulness score 59/100
• Temporal lobe atrophy on MRI in Parkinson disease with dementia: a comparison with Alzheimer disease and dementia with Lewy bodies Neurology · 2005-03-01 · usefulness score 51/100
• Saccadic eye movement changes in Parkinson's disease dementia and dementia with Lewy bodies Brain · 2005-03-17 · usefulness score 50/100
• Gray matter atrophy in Parkinson disease with dementia and dementia with Lewy bodies Neurology · 2007-08-01 · usefulness score 49/100
• REM Sleep Behavior Disorder in Parkinson’s Disease and Dementia with Lewy Bodies Journal of Geriatric Psychiatry and Neurology · 2004-09-01 · usefulness score 36/100
• APOE ε4, white matter hyperintensities, and cognition in Alzheimer and Lewy body dementia Neurology · 2019-10-01 · usefulness score 70/100

Also in Brain scans and imaging

114 studies in the library are filed under Brain scans and imaging with no topic tag they share with another; these are this study's neighbours in a fixed tour of them. The Brain scans and imaging hub.

• Disruption of cerebral networks and cognitive impairment in Alzheimer disease Neurology · 2013-03-13 · usefulness score 46/100 · Brain scans and imaging
• Diverging patterns of amyloid deposition and hypometabolism in clinical variants of probable Alzheimer's disease Brain : a journal of neurology · 2013-01-28 · usefulness score 47/100 · Brain scans and imaging
• The clinical prognosis of cognitively unimpaired individuals with positive PET biomarkers Alzheimer s & Dementia · 2025-12-01 · usefulness score 46/100 · Brain scans and imaging

Similar studies

• Lewy Body Disorders 2017 · Brain tissue and pathology
• Neuropathology of non-motor features of Parkinson disease 2009 · Brain scans and imaging
• Systematic review of pharmacological interventions for people with Lewy body dementia 2023 · Treatments
• Synucleinopathy pathology and REM sleep behavior disorder plus dementia or parkinsonism 2003 · Risk factors
• Diverse limbic comorbidities cause limbic and temporal atrophy in lewy body disease 2022 · Brain tissue and pathology
• Donepezil for Treatment of Dementia With Lewy Bodies: A Case Series of Nine Patients 1998 · Treatments

More on Brain scans and imaging

• A review that covers this ground Visual dysfunction in dementia with Lewy bodies Current neurology and neuroscience reports · 2024-06-22 · usefulness score 43/100
• Newest in this subject Large-scale head-to-head comparison of on- and off-target profiles of [18F]Tauvid and [18F]MK6240 tau-PET in aging and Alzheimer’s disease Research Square · 2026-11-01 · Preprint — not yet peer-reviewed · usefulness score 16/100
• Newest in this subject Repetitive negative thinking is associated with amyloid accumulation over 3 years in cognitively healthy adults medRxiv · 2026-10-31 · Preprint — not yet peer-reviewed · usefulness score 16/100

See all studies in Brain scans and imaging →