Autonomic dysfunction in dementia with Lewy bodies

P. Thaisetthawatkul, B. F. Boeve, E. E. Benarroch, P. Sandroni, T. J. Ferman, R. Petersen, Philip A. Low

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Abstract

Objective: To assess autonomic function in patients with dementia with Lewy bodies (DLB). Methods: The authors compared data from 20 DLB patients evaluated from 1995 to 2000 to 20 age-matched multiple system atrophy (MSA) and Parkinson disease (PD) patients evaluated from 1999 to 2002. Analysis of variance, Fisher exact test, and Student t-test were applied to compare disease characteristics, autonomic symptoms, and function tests on the Composite Autonomic Scoring Scale (CASS) and Thermoregulatory Sweat Test (TST). Results: In DLB, mean age at onset of autonomic symptoms was 70.3 ± 8.9 years. Orthostatic symptoms were common and orthostatic hypotension occurred in 10/20 DLB, 17/20 MSA, and 1/20 PD patients (p = 0.023, 0.003). CASS-sudomotor for DLB, MSA, and PD were 1.6 ± 1.2, 2.5 ± 0.7, and 0.9 ± 0.8 (p < 0.00001). CASS-cardiovagal were 1.4 ± 0.9, 2.1 ± 0.8, and 0. 7 ± 0.6 (p < 0.00001). CASS-adrenergic function were 2.4 ± 1.2, 3.5 ± 0.9, and 0.5 ± 0.6 (p < 0.00001). Total CASS were 5.2 ± 2.0, 8.1 ± 1.3, and 2.2 ± 1.2 (p < 0.00001). The most common pattern of TST in DLB was distal anhidrosis. Mean duration of follow-up was 3.0 ± 1.8 years. Six patients needed medication to maintain blood pressure and five had good response. Conclusions: Autonomic dysfunction is frequent in dementia with Lewy bodies and the severity is intermediate between that of multiple system atrophy and Parkinson disease.

Original languageEnglish (US)
Pages (from-to)1804-1809
Number of pages6
JournalNeurology
Volume62
Issue number10
DOIs
StatePublished - May 25 2004

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ASJC Scopus subject areas

  • Clinical Neurology

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Thaisetthawatkul, P., Boeve, B. F., Benarroch, E. E., Sandroni, P., Ferman, T. J., Petersen, R., & Low, P. A. (2004). Autonomic dysfunction in dementia with Lewy bodies. Neurology, 62(10), 1804-1809. https://doi.org/10.1212/01.WNL.0000125192.69777.6D