Thursday, 17 November 2016

Lewy Body Dementia

Lewy Body Dementia is a disease that causes the loss of cognitive abilities. Although unheard of to many, it is in fact the second largest cause of dementia in the UK, with more than 100,000 sufferers in the UK alone.

The symptoms of the disease include hallucinations, cognitive difficulties, depression, difficulty with movement and many more that are associated with dementia. What symptoms expressed is dependent on the locations of the Lewy Bodies in the brain. A build up of Lewy Bodies in the outer parts of the brain affect the cognitive abilities, thus producing symptoms similar to that of Alzheimer's. Similarly, if found in the base of the brain, movement is affected producing symptom's of Parkinson's Disease.
Image showing Lewy Body proteins in brain cells
(University of Nottingham, 2017)
The disease is not genetically linked therefore cases may arise spontaneously even though the patient has no known family history of the condition. The core cause of the disease is the build up of proteins called alpha-synuclein. In healthy individuals alpha-synuclein is involved in regulating the release of some neurotransmitters between neurones. When deposited in the brain they form aggregates named Lewy Bodies inside neurons, causing reduced levels of neurotransmitters such as dopamine and acetylcholine. As a result the brain's cognitive processes are affected, leading to symptoms associated with dementia.



The disease is often misdiagnosed even though 10-15% of dementia cases are due to Lewy Bodies. This is largely because few doctors are familiar with the disease and its overlap of symptoms with other forms of dementia. Like Alzheimer's, the process of diagnosis may involve examining the patient's motor and cognitive abilities. However, the only definitive indicator of Lewy Body dementia is to certify the presence of the Lewy bodies, and this at present can only be done in a post mortem brain autopsy. 

At the moment, there is no cure for the disease, however some forms of treatment have shown to be effective such as the use of acetylcholinesterase inhibitors in treating the hallucinations associated with Lewy Body dementia. Since the Lewy Body proteins essentially reduces acetylcholine (a common neurotransmitter in the brain), by inhibiting the enzyme that breaks it down, it allows levels of the neurotransmitter to increase thus improve signalling within the brain. Other forms of treatment are physiotherapy to improve motor abilities, occupational therapy and cognitive stimulation to name a few. 

References:


Newman. (2016, 03/11/2016). Brain volume may help diagnose dementia with Lewy bodies. [Article]. Retrieved 3 November 2016, from http://www.medicalnewstoday.com/articles/313853.php


Whiteman(06 November, 2015, no-date)Lewy body dementia: unrecognized and misdiagnosed[Weblog]Retrieved 4 November 2016, from http://www.medicalnewstoday.com/articles/302230.php


NHS(2016). www.nhs.ukRetrieved 4 November, 2016, from http://www.nhs.uk/Conditions/dementia-with-lewy-bodies/Pages/Introduction.aspx



Nihgov(2015)National Institute on AgingRetrieved 7 November, 2016, from https://www.nia.nih.gov/alzheimers/publication/lewy-body-dementia/basics-lewy-body-dementia

O'Sullivan, O.O(2017)Dementia: The diseases behind the wordBiological Sciences Review29(3)18.





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