Top

Published in:

01-12-2013 | DEMENTIA (E MCDADE, SECTION EDITOR)

Treatment of Dementia With Lewy Bodies

Authors: Brendon P. Boot, MBBS, Eric M. McDade, DO, Scott M. McGinnis, MD, Bradley F. Boeve, MD

Published in: Current Treatment Options in Neurology | Issue 6/2013

Opinion statement

Dementia with Lewy bodies (DLB) is a multisystem disorder with diverse disease expression. A treatment regime restricted to the cognitive aspects of the disease does no favor to patients. Instead, patients should be educated to recognize the symptoms of this multisystem involvement. There are no treatments that slow the progression of disease, but symptomatic treatments can be effective. When thinking about treatment, we find it useful to divide the symptoms and signs into five categories: (a) cognitive features, (b) neuropsychiatric features, (c) motor dysfunction, (d) autonomic dysfunction, and (e) sleep dysfunction. Clinicians, funding bodies and industry are increasingly recognizing the importance of this common and debilitating disease.

McKeith I et al. Dementia with Lewy bodies: diagnosis and management: third report of the DLB Consortium. Neurology. 2005;65:1863–72.PubMedCrossRef

McKeith IG et al. Prospective validation of consensus criteria for the diagnosis of dementia with Lewy bodies. Neurology. 2000;54(5):1050–8.PubMedCrossRef

Rahkonen T et al. Dementia with Lewy bodies according to the consensus criteria in a general population aged 75 years or older. J Neurol Neurosurg Psychiatry. 2003;74:720–4.PubMedCrossRef

Zaccai J, McCracken C, Brayne C. A systematic review of prevalence and incidence studies of dementia with Lewy bodies. Age Ageing. 2005;34(6):561–6.PubMedCrossRef

Boeve B. Diagnosis and management of non Alzheimer dementias. In: Noseworthy JW, editor. Neurological therapeutics: principles and practice. 2005.

McKeith IG et al. Consensus guidelines for the clinical and pathologic diagnosis of dementia with Lewy bodies (DLB): report of the consortium on DLB international workshop. Neurology. 1996;47(5):1113–24.PubMedCrossRef

7.•

Vann Jones SA, O’Brien JT. The prevalence and incidence of dementia with Lewy bodies: a systematic review of population and clinical studies. Psychol Med. 2013:1–11. A thorough study of DLB epidemiology, although these are likely understimates.

8.•

Nelson PT et al. Low sensitivity in clinical diagnoses of dementia with Lewy bodies. J Neurol. 2010;257(3):359–66. Study showing that many cases of DLB are not diagnosed during life.PubMedCrossRef

Boot B. Letter to the Editor the incidence and prevalence of dementia with Lewy bodies is underestimated. Psychol Med. 2013:1–2.

10.••

Ferman TJ et al. Inclusion of RBD improves the diagnostic classification of dementia with Lewy bodies. Neurology. 2011;77(9):875–82. Demonstrates that careful diagnosis can lead to accurate identification of patients.PubMedCrossRef

11.••

Boeve BF, et al. Clinicopathologic correlations in 172 cases of rapid eye movement sleep behavior disorder with or without a coexisting neurologic disorder. Sleep Med. 2013. Shows that RBD is highly specific to the synucleinopathies.

12.

Ferman TJ et al. DLB fluctuations: specific features that reliably differentiate DLB from AD and normal aging. Neurology. 2004;62(2):181–7.PubMedCrossRef

13.

Lim SM et al. The 18F-FDG PET cingulate island sign and comparison to 123I-beta-CIT SPECT for diagnosis of dementia with Lewy bodies. J Nucl Med. 2009;50(10):1638–45.PubMedCrossRef

14.

Walker Z et al. Striatal dopamine transporter in dementia with Lewy bodies and Parkinson disease: a comparison. Neurology. 2004;62(9):1568–72.PubMedCrossRef

15.

Walker Z et al. Dementia with Lewy bodies: a comparison of clinical diagnosis, FP-CIT single photon emission computed tomography imaging and autopsy. J Neurol Neurosurg Psychiatry. 2007;78:1176–81.PubMedCrossRef

16.

Treglia G et al. MIBG scintigraphy in differential diagnosis of Parkinsonism: a meta-analysis. Clin Auton Res. 2012;22(1):43–55.PubMedCrossRef

17.

Treglia G, et al. Iodine-123 metaiodobenzylguanidine scintigraphy and iodine-123 ioflupane single photon emission computed tomography in Lewy body diseases: complementary or alternative techniques? J Neuroimaging. 2012.

18.

Jellinger KA. Interaction between pathogenic proteins in neurodegenerative disorders. J Cell Mol Med. 2012;16(6):1166–83.PubMedCrossRef

19.

Jellinger KA. Alpha-synuclein pathology in Parkinson’s and Alzheimer’s disease brain: incidence and topographic distribution—a pilot study. Acta Neuropathol. 2003;106(3):191–201.PubMedCrossRef

20.

Uchikado H et al. Alzheimer disease with amygdala Lewy bodies: a distinct form of alpha-synucleinopathy. J Neuropathol Exp Neurol. 2006;65(7):685–97.PubMedCrossRef

21.

Schneider JA et al. The neuropathology of older persons with and without dementia from community versus clinic cohorts. J Alzheimers Dis. 2009;18(3):691–701.PubMed

22.

Ballard C et al. Psychiatric morbidity in dementia with Lewy bodies: a prospective clinical and neuropathological comparative study with Alzheimer’s disease. Am J Psychiatr. 1999;156(7):1039–45.PubMed

23.

Ballard C et al. Attention and fluctuating attention in patients with dementia with Lewy bodies and Alzheimer disease. Arch Neurol. 2001;58:977–82.PubMedCrossRef

24.

McKeith I et al. Efficacy of rivastigmine in dementia with Lewy bodies: a randomised, double-blind, placebo-controlled international study. Lancet. 2000;356:2031–6.PubMedCrossRef

25.

Aarsland D, Mosimann UP, McKeith IG. Role of cholinesterase inhibitors in Parkinson’s disease and dementia with Lewy bodies. J Geriatr Psychiatry Neurol. 2004;17(3):164–71.PubMedCrossRef

26.

Samuel W et al. Better cognitive and psychopathologic response to donepezil in patients prospectively diagnosed as dementia with Lewy bodies: a preliminary study. Int J Geriatr Psychiatry. 2000;15(9):794–802.PubMedCrossRef

27.•

Mori E, Ikeda M, Kosaka K. Donepezil for dementia with Lewy bodies: a randomized, placebo-controlled trial. Ann Neurol. 2012;72(1):41–52. Evidence for efficacy of donepezil.PubMedCrossRef

28.

Wild R, Pettit T, Burns A. Cholinesterase inhibitors for dementia with Lewy bodies. Cochrane Database Syst Rev. 2003;3, CD003672.PubMed

29.

Levy R et al. Lewy bodies and response to tacrine in Alzheimer’s disease. Lancet. 1994;343(8890):176.PubMedCrossRef

30.

Klein JC et al. Neurotransmitter changes in dementia with Lewy bodies and Parkinson disease dementia in vivo. Neurology. 2010;74(11):885–92.PubMedCrossRef

31.

Rolinski M et al. Cholinesterase inhibitors for dementia with Lewy bodies. Parkinson’s disease dementia and cognitive impairment in Parkinson’s disease. Cochrane Database Syst Rev. 2012;3, CD006504.PubMed

32.

Aarsland D et al. Donepezil for cognitive impairment in Parkinson’s disease: a randomised controlled study. J Neurol Neurosurg Psychiatry. 2002;72(6):708–12.PubMedCrossRef

33.

Emre M et al. Rivastigmine for dementia associated with Parkinson’s disease. N Engl J Med. 2004;351:2509–18.PubMedCrossRef

34.

Ravina B et al. Donepezil for dementia in Parkinson’s disease: a randomised, double blind, placebo controlled, crossover study. J Neurol Neurosurg Psychiatry. 2005;76(7):934–9.PubMedCrossRef

35.•

Emre M et al. Memantine for patients with Parkinson’s disease dementia or dementia with Lewy bodies: a randomised, double-blind, placebo-controlled trial. Lancet Neurol. 2010;9(10):969–77. Evidence for efficacy of memantine.PubMedCrossRef

36.

Aarsland D et al. Memantine in patients with Parkinson’s disease dementia or dementia with Lewy bodies: a double-blind, placebo-controlled, multicentre trial. Lancet Neurol. 2009;8:613–8.PubMedCrossRef

37.

Cummings JL. The Neuropsychiatric Inventory: assessing psychopathology in dementia patients. Neurology. 1997;48(5 Suppl 6):S10–6.PubMedCrossRef

38.

Thomas A et al. Pathological gambling in Parkinson disease is reduced by amantadine. Ann Neurol. 2010;68(3):400–4.PubMedCrossRef

39.••

Boot BP et al. Risk factors for dementia with Lewy bodies: a case-control study. Neurology. 2013;81(9):833–40. Risk factors compared to control subjects; also identifies factors that help to differentiate DLB from AD.PubMedCrossRef

40.

Nelson JC, Devanand DP. A systematic review and meta-analysis of placebo-controlled antidepressant studies in people with depression and dementia. J Am Geriatr Soc. 2011;59(4):577–85.PubMedCrossRef

41.

Banerjee S et al. Sertraline or mirtazapine for depression in dementia (HTA-SADD): a randomised, multicentre, double-blind, placebo-controlled trial. Lancet. 2011;378(9789):403–11.PubMedCrossRef

42.

Weintraub D et al. Antidepressant studies in Parkinson’s disease: a review and meta-analysis. Mov Disord. 2005;20(9):1161–9.PubMedCrossRef

43.

Chung TH et al. Systematic review of antidepressant therapies in Parkinson’s disease. Parkinsonism Relat Disord. 2003;10(2):59–65.PubMedCrossRef

44.••

Seppi K et al. The movement disorder society evidence-based medicine review update: treatments for the non-motor symptoms of Parkinson’s disease. Mov Disord. 2011;26 Suppl 3:S42–80. This excellent evidence-based review covers many issues applicable to DLB patients.PubMedCrossRef

45.

Slaughter JR et al. Prevalence, clinical manifestations, etiology, and treatment of depression in Parkinson’s disease. J Neuropsychiatry Clin Neurosci. 2001;13(2):187–96.PubMedCrossRef

46.

Lemke MR. Depressive symptoms in Parkinson’s disease. Eur J Neurol. 2008;15 Suppl 1:21–5.PubMedCrossRef

47.

Takahashi S et al. Depression associated with dementia with Lewy bodies (DLB) and the effect of somatotherapy. Psychogeriatrics. 2009;9(2):56–61.PubMedCrossRef

48.

Truong DD, Bhidayasiri R, Wolters E. Management of non-motor symptoms in advanced Parkinson disease. J Neurol Sci. 2008;266(1–2):216–28.PubMedCrossRef

49.

Klatka LA, Louis ED, Schiffer RB. Psychiatric features in diffuse Lewy body disease: a clinicopathologic study using Alzheimer’s disease and Parkinson’s disease comparison groups. Neurology. 1996;47(5):1148–52.PubMedCrossRef

50.

Ferman TJ et al. The phenomenology of psychotic features in dementia with Lewy bodies (DLB) and Alheimer’s diesease (AD). Neurology. 2005;64:A257.

51.

Wood LD et al. Clinical review of treatment options for select nonmotor symptoms of Parkinson’s disease. Am J Geriatr Pharmacother. 2010;8(4):294–315.PubMedCrossRef

52.

Kurlan R et al. Quetiapine for agitation or psychosis in patients with dementia and parkinsonism. Neurology. 2007;68(17):1356–63.PubMedCrossRef

53.

Schneider LS, Dagerman K, Insel PS. Efficacy and adverse effects of atypical antipsychotics for dementia: meta-analysis of randomized, placebo-controlled trials. Am J Geriatr Psychiatr. 2006;14(3):191–210.CrossRef

54.

Schneider L et al. Effectiveness of atypical antipsychotic drugs in patients with Alzheimer’s disease. N Engl J Med. 2006;355:1525–38.PubMedCrossRef

55.

Ballard C, Howard R. Neuroleptic drugs in dementia: benefits and harm. Nat Rev Neurosci. 2006;7(6):492–500.PubMedCrossRef

56.

Rochon PA et al. Antipsychotic therapy and short-term serious events in older adults with dementia. Arch Intern Med. 2008;168(10):1090–6.PubMedCrossRef

57.

Musicco M et al. Association between prescription of conventional or atypical antipsychotic drugs and mortality in older persons with Alzheimer’s disease. Dement Geriatr Cogn Disord. 2011;31(3):218–24.PubMedCrossRef

58.

Schneider LS, Dagerman KS, Insel P. Risk of death with atypical antipsychotic drug treatment for dementia: meta-analysis of randomized placebo-controlled trials. JAMA. 2005;294(15):1934–43.PubMedCrossRef

59.

Lopez O, et al. The long-term effects of typical and atypical antipsychotics in patients with Probable Alzheimer’s disease. Am J Psychiatry. (in press).

60.

Aarsland D et al. Neuroleptic sensitivity in Parkinson’s disease and parkinsonian dementias. J Clin Psychiatry. 2005;66(5):633–7.PubMedCrossRef

61.

Ballard C et al. Neuroleptic sensitivity in dementia with Lewy bodies and Alzheimer’s disease. Lancet. 1998;351(9108):1032–3.PubMedCrossRef

62.

McKeith I et al. Neuroleptic sensitivity in patients with senile dementia of Lewy body type. BMJ. 1992;305(6855):673–8.PubMedCrossRef

63.

Rochon PA et al. Atypical antipsychotics and parkinsonism. Arch Intern Med. 2005;165(16):1882–8.PubMedCrossRef

64.

Hassan I. Consultation-liaison psychiatry and prevention of severe neuroleptic sensitivity reactions in dementia with Lewy bodies. Australas Psychiatry. 2011;19(6):536–7.PubMedCrossRef

65.

Johnell K, Religa D, Eriksdotter M. Differences in drug therapy between dementia disorders in the Swedish Dementia Registry: a nationwide study of over 7,000 patients. Dement Geriatr Cogn Disord. 2013;35:239–48.PubMedCrossRef

66.

Ballard C et al. The dementia antipsychotic withdrawal trial (DART-AD): long-term follow-up of a randomised placebo-controlled trial. Lancet Neurol. 2009;8(2):151–7.PubMedCrossRef

67.

Frieling H et al. Treating dopamimetic psychosis in Parkinson’s disease: structured review and meta-analysis. Eur Neuropsychopharmacol. 2007;17(3):165–71.PubMedCrossRef

68.

Friedman JH, Factor SA. Atypical antipsychotics in the treatment of drug-induced psychosis in Parkinson’s disease. Mov Disord. 2000;15(2):201–11.PubMedCrossRef

69.

Schneider F et al. Psychiatric symptoms in Parkinson’s disease. Eur Arch Psychiatry Clin Neurosci. 2008;258 Suppl 5:55–9.PubMedCrossRef

70.

Fernandez HH et al. Long-term outcome of quetiapine use for psychosis among Parkinsonian patients. Mov Disord. 2003;18(5):510–4.PubMedCrossRef

71.

Factor SA et al. Clozapine for the treatment of drug-induced psychosis in Parkinson’s disease: results of the 12-week open-label extension in the PSYCLOPS trial. Mov Disord. 2001;16(1):135–9.PubMedCrossRef

72.

Klein C et al. Clozapine in Parkinson’s disease psychosis: 5-year follow-up review. Clin Neuropharmacol. 2003;26(1):8–11.PubMedCrossRef

73.

Pollak P et al. Clozapine in drug induced psychosis in Parkinson’s disease: a randomised, placebo controlled study with open follow up. J Neurol Neurosurg Psychiatry. 2004;75(5):689–95.PubMedCrossRef

74.

Morgante L et al. Quetiapine and clozapine in parkinsonian patients with dopaminergic psychosis. Clin Neuropharmacol. 2004;27(4):153–6.PubMedCrossRef

75.

Merims D et al. Rater-blinded, prospective comparison: quetiapine versus clozapine for Parkinson’s disease psychosis. Clin Neuropharmacol. 2006;29(6):331–7.PubMedCrossRef

76.

Husebo BS, Ballard C, Aarsland D. Pain treatment of agitation in patients with dementia: a systematic review. Int J Geriatr Psychiatry. 26(10):1012–8.

77.

Cohen-Mansfield J, Libin A, Marx MS. Nonpharmacological treatment of agitation: a controlled trial of systematic individualized intervention. J Gerontol A Biol Sci Med Sci. 2007;62(8):908–16.PubMedCrossRef

78.••

Brodaty H, Arasaratnam C. Meta-analysis of nonpharmacological interventions for neuropsychiatric symptoms of dementia. Am J Psychiatry. 169(9):946–53. An excellent review of treatment for all-cause dementia.

79.

Rhodes-Kropf J et al. Managing the patient with dementia in long-term care. Clin Geriatr Med. 2011;27(2):135–52.PubMedCrossRef

80.

Ballard C et al. Brief psychosocial therapy for the treatment of agitation in Alzheimer disease (the CALM-AD trial). Am J Geriatr Psychiatr. 2009;17(9):726–33.CrossRef

81.

Konovalov S, Muralee S, Tampi RR. Anticonvulsants for the treatment of behavioral and psychological symptoms of dementia: a literature review. Int Psychogeriatr. 2008;20(2):293–308.PubMedCrossRef

82.

Hicks SW et al. Valproate for the treatment of medication-induced impulse-control disorders in three patients with Parkinson’s disease. Parkinsonism Relat Disord. 2011;17(5):379–81.PubMedCrossRef

83.

Hasnain M et al. Pharmacological management of psychosis in elderly patients with parkinsonism. Am J Med. 2009;122(7):614–22.PubMedCrossRef

84.

Molloy S et al. The role of levodopa in the management of dementia with Lewy bodies. J Neurol Neurosurg Psychiatry. 2005;76(9):1200–3.PubMedCrossRef

85.

Lucetti C et al. Levodopa response in dementia with lewy bodies: a 1-year follow-up study. Parkinsonism Relat Disord. 2010;16(8):522–6.PubMedCrossRef

86.

Lawrence J, Parmenter T, McDonald T. Failure to manage constipation in Parkinson’s disease. A review of medical services a patients perspective. Mov Disord. 2013;28 Suppl 1:187.

87.

Jost WH. Gastrointestinal motility problems in patients with Parkinson’s disease. Effects of antiparkinsonian treatment and guidelines for management. Drugs Aging. 1997;10(4):249–58.PubMedCrossRef

88.

Ashraf W et al. Constipation in Parkinson’s disease: objective assessment and response to psyllium. Mov Disord. 1997;12(6):946–51.PubMedCrossRef

89.

Zangaglia R et al. Macrogol for the treatment of constipation in Parkinson’s disease. A randomized placebo-controlled study. Mov Disord. 2007;22(9):1239–44.PubMedCrossRef

90.

Ondo WG et al. Placebo-controlled trial of lubiprostone for constipation associated with Parkinson disease. Neurology. 2012;78(21):1650–4.PubMedCrossRef

91.

Thaisetthawatkul P et al. Autonomic dysfunction in dementia with Lewy bodies. Neurology. 2004;62(10):1804–9.PubMedCrossRef

92.

Hishikawa N et al. Clinical and neuropathological correlates of Lewy body disease. Acta Neuropathol (Berl). 2003;105:341–50.

93.

Schoffer KL et al. Nonpharmacological treatment, fludrocortisone, and domperidone for orthostatic hypotension in Parkinson’s disease. Mov Disord. 2007;22(11):1543–9.PubMedCrossRef

94.

Sakakibara R et al. Lower urinary tract function in dementia of Lewy body type. J Neurol Neurosurg Psychiatry. 2005;76(5):729–32.PubMedCrossRef

95.

Ziemssen T, Reichmann H. Non-motor dysfunction in Parkinson’s disease. Parkinsonism Relat Disord. 2007;13(6):323–32.PubMedCrossRef

96.

Kay GG et al. Antimuscarinic drugs for overactive bladder and their potential effects on cognitive function in older patients. J Am Geriatr Soc. 2005;53(12):2195–201.PubMedCrossRef

97.

Pagoria D, O’Connor RC, Guralnick ML. Antimuscarinic drugs: review of the cognitive impact when used to treat overactive bladder in elderly patients. Curr Urol Rep. 2011;12(5):351–7.PubMedCrossRef

98.

Todorova A, Vonderheid-Guth B, Dimpfel W. Effects of tolterodine, trospium chloride, and oxybutynin on the central nervous system. J Clin Pharmacol. 2001;41(6):636–44.PubMedCrossRef

99.

Zesiewicz TA, Helal M, Hauser RA. Sildenafil citrate (Viagra) for the treatment of erectile dysfunction in men with Parkinson’s disease. Mov Disord. 2000;15(2):305–8.PubMedCrossRef

100.

Hussain IF et al. Treatment of erectile dysfunction with sildenafil citrate (Viagra) in parkinsonism due to Parkinson’s disease or multiple system atrophy with observations on orthostatic hypotension. J Neurol Neurosurg Psychiatry. 2001;71(3):371–4.PubMedCrossRef

101.

Hassan A et al. Dopamine agonist-triggered pathological behaviors: surveillance in the PD clinic reveals high frequencies. Parkinsonism Relat Disord. 2011;17(4):260–4.PubMedCrossRef

102.

Malhotra R, Avidan AY. Neurodegenerative disease and REM behavior disorder. Curr Treat Options Neurol. 2012;14(5):474–92.PubMedCrossRef

103.

Hogl B et al. Modafinil for the treatment of daytime sleepiness in Parkinson’s disease: a double-blind, randomized, crossover, placebo-controlled polygraphic trial. Sleep. 2002;25(8):905–9.PubMed

104.

Kuntz K, et al. Safety, tolerability, and efficacy of armodafinil therapy for hypersomnia associated with dementia with Lewy bodies. Neurology. 2012;(78):P04.192.

105.

Howell MJ, Arneson PA, Schenck CH. A novel therapy for REM sleep behavior disorder (RBD). J Clin Sleep Med. 2011;7(6):639–44.PubMed

106.

Boeve B, Silber M, Ferman T. Melatonin for treatment of REM sleep behavior disorder in neurologic disorders: results in 14 patients. Sleep Med. 2003;4:281–4.PubMedCrossRef

107.

Dowling GA et al. Melatonin for sleep disturbances in Parkinson’s disease. Sleep Med. 2005;6(5):459–66.PubMedCrossRef

108.

Medeiros CA et al. Effect of exogenous melatonin on sleep and motor dysfunction in Parkinson’s disease. A randomized, double blind, placebo-controlled study. J Neurol. 2007;254(4):459–64.PubMedCrossRef

109.

Mace N, Rabins P. The 36-hour day: a family guide to caring for persons with Alzheimer disease, related dementing illnesses, and memory loss in later life. 5th ed. Baltimore: JHUP; 2011.

110.

Chenoweth L et al. Caring for Aged Dementia Care Resident Study (CADRES) of person-centred care, dementia-care mapping, and usual care in dementia: a cluster-randomised trial. Lancet Neurol. 2009;8(4):317–25.PubMedCrossRef

111.

Moyle W et al. The effect of massage on agitated behaviours in older people with dementia: a literature review. J Clin Nurs. 2013;22(5–6):601–10.PubMed

112.

Holliday-Welsh DM, Gessert CE, Renier CM. Massage in the management of agitation in nursing home residents with cognitive impairment. Geriatr Nurs. 2009;30(2):108–17.PubMedCrossRef

113.

Ueda T et al. Effects of music therapy on behavioral and psychological symptoms of dementia: a systematic review and meta-analysis. Ageing Res Rev. 2013;12(2):628–41.PubMedCrossRef

114.

Raglio A et al. Music, music therapy and dementia: a review of literature and the recommendations of the Italian Psychogeriatric Association. Maturitas. 2012;72(4):305–10.PubMedCrossRef

115.

Iranzo A et al. Decreased striatal dopamine transporter uptake and substantia nigra hyperechogenicity as risk markers of synucleinopathy in patients with idiopathic rapid-eye-movement sleep behaviour disorder: a prospective study. Lancet Neurol. 2010;9(11):1070–7.PubMedCrossRef

116.

McDade EM, Boot BP, Christianson TJ, Pankratz VS, Boeve BF, Ferman TJ, et al. Subtle gait changes in patients with REM sleep behavior disorder. Mov Disord. 2013. doi:10.1002/mds.25653.

117.

Boeve B. REM sleep behavior disorder: updated review of the core features, the REM sleep behavior disorder-neurodegenerative disease association, evolving concepts, controversies, and future directions. Ann N Y Acad Sci. 2010;1184:17–56.CrossRef

Title: Treatment of Dementia With Lewy Bodies
Authors: Brendon P. Boot, MBBS
Eric M. McDade, DO
Scott M. McGinnis, MD
Bradley F. Boeve, MD
Publication date: 01-12-2013
Publisher: Springer US
Published in: Current Treatment Options in Neurology / Issue 6/2013
Print ISSN: 1092-8480
Electronic ISSN: 1534-3138
DOI: https://doi.org/10.1007/s11940-013-0261-6

At a glance: The STEP trials

Springer Medicine

Treatment of Dementia With Lewy Bodies

Opinion statement

At a glance: The STEP trials

Springer Medicine

Opinion statement

Please log in to get access to this content

Other articles of this Issue 6/2013

Alzheimer’s Disease, Sleep Apnea, and Positive Pressure Therapy

Complex Sleep Apnea

Immunotherapeutics for Autoimmune Encephalopathies and Dementias

Comorbid Insomnia and Sleep Disordered Breathing

Nonpharmacologic Treatment of Behavioral Disorders in Dementia

Sleep-Related Headache and its Management