J Neurol Neurosurg Psychiatry doi:10.1136/jnnp-2012-304694
  • Editorial commentary

Does cognitive profile distinguish Lewy body disease from Alzheimer's disease in the early stages?

  1. F Blanc
  1. Correspondence to Dr Frederic Blanc, Neuropsychology Unit and Centre Memoire de Ressources et de Recherche, Service of Neurology, University Hospital of Strasbourg 1, avenue Molière, Strasbourg 67000, France, and ICube (University of Strasbourg and CNRS), 1, place de l'Hôpital, Strasbourg 67000, France; Frederic.Blanc{at}
  • Received 8 January 2013
  • Revised 14 March 2013
  • Accepted 20 March 2013
  • Published Online First 16 April 2013

Lewy body disease (LBD) is the second most frequent neurodegenerative disease after Alzheimer's disease (AD).1 To distinguish these two pathologies seems to be of less importance at this time since AD and LBD have the same symptomatic treatment (cholinesterase inhibitors). However, new specific treatments emerge in AD with precise targets against brain lesions.2 Moreover frequent symptoms of LBD such as hallucinations and delusions do not have to be treated by usual neuroleptics and antipsychotics, since such treatment aggravate patients physically and cognitively.3

The diagnosis of LBD is difficult for clinicians, even for specialists, particularly at the beginning of the disease. The diagnosis criteria, known as McKeith criteria, have a really high specificity—more than 95%—for LBD dementia.4 ,5 The sensitivity of such criteria was found to be 83%, using a cohort of 50 patients.5 In a bigger cohort of 2861 patients, with less …

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