Diseases and Disorders

Lewy Body Dementia

Alexander Skvortsov


    Robin Williams was a well-known actor, comedian, and philanthropist. Starring in movies such as Dead Poet’s Society and Good WIll Hunting, as well as numerous shows and standup comedy productions, Robin was widely considered one of the best comedians of the late 20th century, and embodied the very heart and soul of comedy.

    Robin Williams committed suicide in 2014. For several months before his death, his widow and colleagues reported him as exhibiting unusual conditions, in particular depression and paranoia. However, Robin wasn’t just feeling down. An autopsy after his death revealed that he was likely suffering from Lewy Body Dementia. ("Robin Williams and Lewy Body Dementia", 2014).

    Many people are familiar with Alzheimer’s, but few know that Lewy Body Dementia, or LBS, is the second leading cause of dementia in the world. Approximately 1.4 million Americans suffer from Lewy Body Dementia every year, second only to Alzheimer’s in terms of neurodegenerative diseases. It is also one of the most misdiagnosed neurological diseases in America ("What is LBD?", n.d.). Lewy Body Dementia is a blanket term for two specific dementias: Parkinson’s Disease Dementia and Dementia with Lewy Bodies (DLB). Both Lewy Body Dementias are caused by abnormal buildup of proteins called Lewy Bodies: aggregates of proteins inside neurons. Lewy Bodies were discovered in the early 1910s by Frederic Lewy while researching Parkinson’s, and were later named in his honor by Russian neuropathologist Konstantin Trétiakoff (Lewy Body Dementia: Information for Patients, Families, and Professionals, 2015).

 

Cause and Types

    While we do not know specific causes of LBD, there are many features associated with it, such as Lewy Bodies. Lewy Bodies are abnormal buildups of the protein alpha-synuclein. Alpha-synuclein is usually abundant throughout the brain, found at presynaptic terminals. While scientists do not know its exact function, we do know that alpha-synuclein plays a role in neural communication (Lewy Body Dementia: Information for Patients, Families, and Professionals, 2015). Alpha synuclein buildups impede the function of, and later kill, the affected neuron- generally cholinergic or dopaminergic.  Acetylcholine is important for memory and learning, and dopamine is heavily tied to mood, movement, sleep, cognition, and behavior. The primary brain region affected by Lewy Bodies is the substantia nigra in the midbrain, although other brain regions are affected, especially the cortex, limbic system, hippocampus, and brainstem (Lewy Body Dementia: Information for Patients, Families, and Professionals, 2015).

    As aforementioned, there are two classifications of Lewy Body Syndrome: Dementia with Lewy Bodies, and Parkinson’s Disease Dementia. DLB starts off almost identical to Alzheimer’s, with patients experiencing declines in thinking and memory problems. However, over time, various symptoms arise which differentiate Dementia with Lewy Bodies from Alzheimer’s Disease. The primary difference is parkinsonism, or movement conditions similar to those experiences with Parkinson’s.

    The other type of LBD is Parkinson’s Disease Dementia. Parkinson’s Disease Dementia is an aspect of Parkinson’s that develops as a dementia, alongside the usual movement disabilities. Not all Parkinson’s patients will develop Parkinson’s Disease Dementia, but it is considered that getting Parkinson’s later in life increases your chances of contracting PDD as well.

 

Symptoms

    Lewy Body Dementia primarily affects cognitive function. LBD is classified as a dementia, and so patients exhibit dementia-like symptoms. A dementia is classified as “a decline in mental ability severe enough to interfere with daily life”(“What is Dementia?,” Alzheimer’s Association).  Dementia can result in confusion as well as problems with multitasking, reasoning, performing basic tasks, spatial abilities, coordination. Memory loss generally arises later in LBD, while in Alzheimer’s memory loss is present in early stages (Lewy Body Dementia: Information for Patients, Families, and Professionals, 2015).

    As stated above, parkinsonian movement disorders are also prevalent among LBD patients, especially amongst Parkinson’s Disease Dementia patients. These include difficulty of movement, tremors, and rigidity. Other differentiating symptoms can be REM sleep disorders, and hallucinations. Patients of Dementia with Lewy Bodies can also acquire parkinsonian symptoms later in life, albeit less often than PDD patients (Lewy Body Dementia: Information for Patients, Families, and Professionals, 2015).

    In addition to cognitive and movement impediments, there are several other major symptoms of Lewy Body Dementias. Sleep disorders are prevalent among LBD sufferers, primarily REM disorders, but also insomnia or excessive sleepiness. Most of these sleep symptoms set in early, before LBD diagnosis (Lewy Body Dementia: Information for Patients, Families, and Professionals, 2015).

    Mood symptoms can also be common among LBD patients. Depression and paranoia, both of which afflicted Robin Williams, are common, as well as anxiety, agitations, or delusions. Hallucinations are also rare, but present (Lewy Body Dementia: Information for Patients, Families, and Professionals, 2015).

    Lewy Body Dementia is a harsh, brutal neurodegenerative disease that affects millions of people. While we do not currently have ways of curing LBD, scientists will continue into the future to seek better treatment options, and, ultimately, total prevention and eradication procedures for LBD, as well as for other neurodegenerative disorders.


References


  1. Robin Williams and Lewy Body Dementia. (2014). Lewy Body Dementia Association. Retrieved 20 June 2016, from https://www.lbda.org/content/robin-williams-and-lewy-body-dementia What is Dementia? Retrieved June 28, 2016, from Alzheimer’s Association, http://www.alz.org/what-is-dementia.asp

  2. What is LBD?. Lewy Body Dementia Association. Retrieved 20 June 2016, from https://www.lbda.org/category/3437/what-is-lbd.htm

  3. Lewy Body Dementia: Information for Patients, Families, and Professionals. (2015) (1st ed.). Retrieved from https://www.nia.nih.gov/alzheimers/publication/lewy-body-dementia/introduction

  4. Dementia With Lewy Bodies. (2016). Alzheimer's Association. Retrieved 20 June 2016, from http://www.alz.org/dementia/dementia-with-lewy-bodies-symptoms.asp

Alexander Skvortsov

Alexander Skvortsov


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