Dataset Information

Respiratory dysrhythmia in dementia with Lewy bodies: a cross-sectional study.

ABSTRACT:

Objectives

Dementia with Lewy bodies (DLB) is the second most common form of neurodegenerative dementia after Alzheimer's disease (AD). DLB is characterised by intracytoplasmic inclusions called Lewy bodies that are often seen in the brainstem. Because modulation of the respiratory rhythm is one of the most important functions of the brainstem, patients with DLB may exhibit dysrhythmic breathing. This hypothesis has not yet been systematically studied. Therefore, we evaluated the association between DLB and dysrhythmic breathing.

Design

In this cross-sectional study consecutive inpatients who were admitted for the evaluation of progressive cognitive impairment were enrolled. We assessed breathing irregularity using polysomnographic recordings on bed rest with closed eyes, without reference to the clinical differentiation among DLB, AD and having no dementia.

Setting

Single centre in Japan.

Participants

14 patients with DLB , 21 with AD and 12 without dementia were enrolled in this study.

Primary outcome measures

The coefficient of variation (CV) of the breath-to-breath time was calculated. We also examined the amplitude spectrum A(f) obtained using the fast Fourier transform and Shannon entropy S of A(f) in patients with DLB compared with patients with AD and patients without dementia.

Results

The values of CV and entropy S were significantly higher in patients with DLB than in patients with AD and patients without dementia. No significant differences were observed between patients with AD and patients without dementia.

Conclusions

Patients with DLB exhibit dysrhythmic breathing compared with patients with AD and patients without dementia. Dysrhythmic breathing is a new clinical feature of DLB and the spectral analysis of breathing patterns can be clinically useful for the diagnostic differentiation of DLB from AD.

SUBMITTER: Hibi S

PROVIDER: S-EPMC3773650 | biostudies-literature | 2013 Sep

REPOSITORIES: biostudies-literature

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Publications

Respiratory dysrhythmia in dementia with Lewy bodies: a cross-sectional study.

Hibi Shinichiro S Yamaguchi Yasuhiro Y Umeda-Kameyama Yumi Y Iijima Katsuya K Takahashi Miwako M Momose Toshimitsu T Akishita Masahiro M Ouchi Yasuyoshi Y

BMJ open 20130910 9

<h4>Objectives</h4>Dementia with Lewy bodies (DLB) is the second most common form of neurodegenerative dementia after Alzheimer's disease (AD). DLB is characterised by intracytoplasmic inclusions called Lewy bodies that are often seen in the brainstem. Because modulation of the respiratory rhythm is one of the most important functions of the brainstem, patients with DLB may exhibit dysrhythmic breathing. This hypothesis has not yet been systematically studied. Therefore, we evaluated the associa ...[more]

PMID: 24022387

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Project description:BackgroundUnderstanding the treatment needs of patients with dementia with Lewy bodies (DLB) is essential to develop treatment strategies. We examined the treatment needs of patients with DLB and their caregivers and the extent to which the attending physicians understand these treatment needs.MethodsThis was a cross-sectional, observational study conducted using questionnaires for patients, caregivers, and physicians. The study participants included patients, their caregivers, and their attending physicians who were experts in DLB. Fifty-two symptoms that are frequent and clinically important in DLB were pre-selected and classified into seven symptom domains. Treatment needs of patients and caregivers were defined as "symptom that causes them most distress," and the frequency of each answer was tabulated. To assess the physician's understanding of the treatment needs of patients and caregivers, patient-physician and caregiver-physician concordance rates for each answer regarding treatment needs were calculated according to symptom domains.ResultsIn total, 263 pairs of patients-caregivers and 38 physicians were surveyed. The mean age of patients was 79.3 years, and their mean total score on the Mini-Mental State Examination was 20.9. Thirty-five and 38 symptoms were selected as symptoms causing patients and caregivers most distress, respectively. Memory impairment was most frequently selected for the treatment needs of patients, followed by constipation and bradykinesia. Memory impairment was also most frequently selected by caregivers, followed by visual hallucinations. For the symptom domain that causes patients or caregivers most distress, only about half of the patient-physician pairs (46.9%) and caregiver-physician pairs (50.8%) were matched. Logistic regression analysis identified that concordance rates for treatment needs between patient-physician and caregiver-physician were lower when autonomic dysfunction and sleep-related disorders were selected as the symptom domains that cause most distress.ConclusionThere was considerable variability in the treatment needs of patients with DLB and their caregivers. Attending physicians had difficulty understanding the top treatment needs of their patients and caregivers, despite their expertise in DLB, because of various clinical manifestations. Attending physicians should pay more attention to autonomic dysfunction and sleep-related disorders in the treatment of DLB.Trial registrationUMIN Clinical Trials Registry, UMIN000041844. Registered on 23 September 2020.

Dataset Information

Respiratory dysrhythmia in dementia with Lewy bodies: a cross-sectional study.

Objectives

Design

Setting

Participants

Primary outcome measures

Results

Conclusions

Publications

Respiratory dysrhythmia in dementia with Lewy bodies: a cross-sectional study.

Similar Datasets

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