BRAIN and NERVE－神経研究の進歩68巻2号

2016年02月発行

総説

レヴィ小体型認知症の臨床神経心理学

著者： 長濱康弘¹

所属機関： ¹医療法人花咲会 かわさき記念病院

ページ範囲：P.165 - P.174

文献概要

レヴィ小体型認知症（DLB）はアルツハイマー病（AD）に比べると，記憶障害が軽く視空間機能障害が強い。DLBの記憶障害には保持/固定障害，想起障害の両者が関与しているが，ADに比べると想起障害の影響が大きい。視空間機能は高次視覚処理の背側路，腹側路ともに障害がみられるほか，低次の視覚認知にも障害が示唆されている。注意・遂行機能はADに比べて広範に障害される。片手指パターンの模倣はDLBでは他の認知症に比べ障害されやすく診断の一助になる。パレイドリアは幻視と視覚認知障害の中間の現象で，DLBで頻度が高いがその機序は未解明である。

　

※「Fig. 1　ADとDLBにおけるCDTと立方体模写の例」，「Fig. 2　ADとDLBにおけるCDTとCOPYの成績」は，権利者の意向等により冊子体のみの掲載になります．

参考文献

1)McKeith IG, Dickson DW, Lowe J, Emre M, O'Brien JT, et al: Diagnosis and management of dementia with Lewy bodies: third report of the DLB Consortium. Neurology 65: 1863-1872, 2005

2)Calderon J, Perry RJ, Erzinclioglu SW, Berrios GE, Dening TR, et al: Perception, attention, and working memory are disproportionately impaired in dementia with Lewy bodies compared with Alzheimer's disease. J Neurol Neurosurg Psychiatry 70: 157-164, 2001

3)Kraybill ML, Larson EB, Tsuang DW, Teri L, McCormick WC, et al: Cognitive differences in dementia patients with autopsy-verified AD, Lewy body pathology, or both. Neurology 64: 2069-2073, 2005

4)Oda H, Yamamoto Y, Maeda K: The neuropsychological profile in dementia with Lewy bodies and Alzheimer's disease. Int J Geriatr Psychiatry 24: 125-131, 2009

5)Hamilton JM, Salmon DP, Galasko D, Delis DC, Hansen LA, et al: A comparison of episodic memory deficits in neuropathologically-confirmed dementia with Lewy bodies and Alzheimer's disease. J Int Neuropsychol Soc 10: 689-697, 2004

6)Economou A, Routsis C, Papageorgiou SG: Episodic memory in alzheimer disease, frontotemporal dementia, and dementia with lewy bodies/parkinson disease dementia: disentangling retrieval from consolidation. Alzheimer Dis Assoc Disord 2015 Mar 6.［Epub ahead of print］doi: 10.1097/WAD.0000000000000089

7)Lambon Ralph MA, Powell J, Howard D, Whitworth AB, Garrard P, et al: Semantic memory is impaired in both dementia with Lewy bodies and dementia of Alzheimer's type: a comparative neuropsychological study and literature review. J Neurol Neurosurg Psychiatry 70: 149-156, 2001

8)Collerton D, Burn D, McKeith I, O'Brien J: Systematic review and meta-analysis show that dementia with Lewy bodies is a visual-perceptual and attentional-executive dementia. Dement Geriatr Cogn Disord 16: 229-237, 2003

9)長濱康弘: レビー小体型認知症の認知機能障害. 老年精神医学雑誌17: 400-407, 2006

10)Tiraboschi P, Salmon DP, Hansen LA, Hofstetter RC, Thal LJ, et al: What best differentiates Lewy body from Alzheimer's disease in early-stage dementia? Brain 129: 729-735, 2006

11)Cagnin A, Bussè C, Jelcic N, Gnoato F, Mitolo M, et al: High specificity of MMSE pentagon scoring for diagnosis of prodromal dementia with Lewy bodies. Parkinsonism Relat Disord 21: 303-305, 2015

12)Gnanalingham KK, Byrne EJ, Thornton A, Sambrook MA, Bannister P: Motor and cognitive function in Lewy body dementia: comparison with Alzheimer's and Parkinson's diseases. J Neurol Neurosurg Psychiatry 62: 243-252, 1997

13)Calderon J, Perry RJ, Erzinclioglu SW, Berrios GE, Dening TR, et al: Perception, attention, and working memory are disproportionately impaired in dementia with Lewy bodies compared with Alzheimer's disease. J Neurol Neurosurg Psychiatry 70: 157-164, 2001

14)Mori E, Shimomura T, Fujimori M, Hirono N, Imamura T, et al: Visuoperceptual impairment in dementia with Lewy bodies. Arch Neurol 57: 489-493, 2000

15)Mosimann UP, Mather G, Wesnes KA, O'Brien JT, Burn DJ, et al: Visual perception in Parkinson disease dementia and dementia with Lewy bodies. Neurology 63: 2091-2096, 2004

16)Landy KM, Salmon DP, Galasko D, Filoteo JV, Festa EK, et al: Motion discrimination in dementia with Lewy bodies and Alzheimer disease. Neurology 85: 1376-1382, 2015

17)Metzler-Baddeley C, Baddeley RJ, Lovell PG, Laffan A, Jones RW: Visual impairments in dementia with Lewy bodies and posterior cortical atrophy. Neuropsychology 24: 35-48, 2010

18)Perry RJ, Hodges JR: Attention and executive deficits in Alzheimer's disease. A critical review. Brain 122: 383-404, 1999

19)長濱康弘, 翁　朋子, 鈴木則夫, 松田　実: レビー小体型痴呆の臨床症状と認知機能の特徴. 老年精神医学雑誌15: 759-766, 2004

20)Johnson DK, Morris JC, Galvin JE: Verbal and visuospatial deficits in dementia with Lewy bodies. Neurology 65: 1232-1238, 2005

21)Kawai Y, Miura R, Tsujimoto M, Sakurai T, Yamaoka A, et al: Neuropsychological differentiation between Alzheimer's disease and dementia with Lewy bodies in a memory clinic. Psychogeriatrics 13: 157-163, 2013

22)Johns EK, Phillips NA, Belleville S, Goupil D, Babins L, et al: Executive functions in frontotemporal dementia and Lewy body dementia. Neuropsychology 23: 765-777, 2009

23)長濱康弘: レビー小体型認知症（DLB）における認知機能障害に対する薬物治療. 精神科治療学28: 1597-1602, 2013

24)長濱康弘, 翁　朋子, 生天目英比古, 松田　実, 村上元庸: 痴呆症におけるclock drawingの定量的評価法: 信頼性ならびに神経心理学検査との関連性の検討. 臨床神経41: 653-658, 2001

25)Smits LL, Flapper M, Sistermans N, Pijnenburg YA, Scheltens P, et al: Apraxia in mild cognitive impairment and Alzheimer's disease: validity and reliability of the van heugten test for apraxia. Dement Geriatr Cogn Disord 38: 55-64, 2014

26)Yamaguchi H, Takahashi S, Kosaka K, Okamoto K, Yamazaki T, et al: Yamaguchi fox-pigeon imitation test (YFPIT) for dementia in clinical practice. Psychogeriatrics 11: 221-226, 2011

27)Nagahama Y, Okina T, Suzuki N: Impaired imitation of gestures in mild dementia: comparison of dementia with Lewy bodies, Alzheimer's disease and vascular dementia. J Neurol Neurosurg Psychiatry 86: 1248-1252, 2015

28)Mak E, Li S, Williams GB, Watson R, Firbank M, et al: Differential Atrophy of Hippocampal Subfields: A Comparative Study of Dementia with Lewy Bodies and Alzheimer Disease. Am J Geriatr Psychiatry. 2015 Jun 25［Epub ahead of print］doi: 10.1016/j.jagp.2015.06.006.

29)Gross RG, McMillan CT, Chandrasekaran K, Dreyfuss M, Ash S, et al: Sentence processing in Lewy body spectrum disorder: the role of working memory. Brain Cogn 78: 85-93, 2012

30)Ash S, McMillan C, Gross RG, Cook P, Gunawardena D, et al: Impairments of speech fluency in Lewy body spectrum disorder. Brain Lang 120: 290-302, 2012

31)Nagahama Y, Okina T, Suzuki N, Matsuda M: Cerebral substrates related to impaired performance in the clock-drawing test in dementia with Lewy bodies. Dement Geriatr Cogn Disord 25: 524-530, 2008

32)Nagahama Y, Okina T, Suzuki N, Nabatame H, Matsuda M: Neural correlates of impaired performance on the clock drawing test in Alzheimer's disease. Dement Geriatr Cogn Disord 19: 390-396, 2005

33)Nagahama Y, Okina T, Suzuki N, Matsuda M, Fukao K, et al: Classification of psychotic symptoms in dementia with Lewy bodies. Am J Geriatr Psychiatry 15: 961-917, 2007

34)長濱康弘: BPSDの初期症状. 老年精神医学雑誌26（増刊-1）: 40-46, 2015

35)Uchiyama M, Nishio Y, Yokoi K, Hirayama K, Imamura T, et al: Pareidolias: complex visual illusions in dementia with Lewy bodies. Brain 135: 2458-2469, 2012

36)Yokoi K, Nishio Y, Uchiyama M, Shimomura T, Iizuka O, et al: Hallucinators find meaning in noises: pareidolic illusions in dementia with Lewy bodies. Neuropsychologia 56: 245-254, 2014

37)Uchiyama M, Nishio Y, Yokoi K, Hosokai Y, Takeda A, et al: Pareidolia in Parkinson's disease without dementia: A positron emission tomography study. Parkinsonism Relat Disord 21: 603-609, 2015

38)Nagahama Y, Okina T, Suzuki N, Matsuda M: Neural correlates of psychotic symptoms in dementia with Lewy bodies. Brain 133: 557-567, 2010

39)Ferman TJ, Smith GE, Boeve BF, Ivnik RJ, Petersen RC, et al: DLB fluctuations. Specific features that reliably differentiate DLB from AD and normal aging. Neurology 62: 181-187, 2004

40)Walker MP, Ayre GA, Cummings JL, Wesnes K, McKeith IG, et al: Quantifying fluctuation in dementia with Lewy bodies, Alzheimer's disease, and vascular dementia. Neurology 54: 1616-1625, 2000

41)Doubleday EK, Snowden JS, Varma AR, Neary D: Qualitative performance characteristics differentiate dementia with Lewy bodies and Alzheimer's disease. J Neurol Neurosurg Psychiatry 72: 602-607, 2002

42)Hamilton JM, Salmon DP, Galasko D, Delis DC, Hansen LA, et al: A comparison of episodic memory deficits in neuropathologically-confirmed dementia with Lewy bodies and Alzheimer's disease. J Int Neuropsychol Soc 10: 689-697, 2004

43)Walker MP, Ayre GA, Cummings JL, Wesnes K, McKeith IG, et al: The clinician assessment of fluctuation and the one day fluctuation assessment scale. Two methods to assess fluctuating confusion in dementia. Br J Psychiatry 177: 252-256, 2000

44)Lee DR, McKeith I, Mosimann U, Ghosh-Nodial A, Grayson L, et al: The dementia cognitive fluctuation scale, a new psychometric test for clinicians to identify cognitive fluctuations in people with dementia. Am J Geriatr Psychiatry 22: 926-935, 2014

45)Taylor JP, Colloby SJ, McKeith IG, O'Brien JT: Covariant perfusion patterns provide clues to the origin of cognitive fluctuations and attentional dysfunction in dementia with Lewy bodies. Int Psychogeriatr 25: 1917-1928, 2013

46)Peraza LR, Kaiser M, Firbank M, Graziadio S, Bonanni L, et al: fMRI resting state networks and their association with cognitive fluctuations in dementia with Lewy bodies. Neuroimage Clin 4: 558-565, 2014

47)Bliwise DL, Scullin MK, Trotti LM: Fluctuations in cognition and alertness vary independently in dementia with Lewy bodies. Mov Disord 29: 83-89, 2014

48)Gore RL, Vardy ER, O'Brien JT: Delirium and dementia with Lewy bodies: distinct diagnoses or part of the same spectrum? J Neurol Neurosurg Psychiatry 86: 50-59, 2015