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. 2021 Oct;268(10):3886-3896.
doi: 10.1007/s00415-021-10539-0. Epub 2021 Apr 8.

LeSCoD: a new clinical scale for the detection of Lewy body disease in neurocognitive disorders

Pauline Olivieri  1   2 , Thibaud Lebouvier  3 , Jean-Benoît Hardouin  4   5 , Hélène Courtemanche  6   7 , Séverine Le Dily  7 , Laëtitia Barbin  7 , Amandine Pallardy  8 , Pascal Derkinderen  9 , Claire Boutoleau-Bretonnière  10   11   12
Affiliations

LeSCoD: a new clinical scale for the detection of Lewy body disease in neurocognitive disorders

Pauline Olivieri et al. J Neurol. 2021 Oct.

Abstract

Background: Dementia with Lewy bodies remains underdiagnosed in clinical practice mainly because of the low sensitivity of existing diagnostic criteria and a strong overlap with Alzheimer's pathology that can mask the Lewy phenotype.

Objective: The objective of this study was therefore to develop and validate a new clinical scale designed to detect signs of Lewy body disease, called LeSCoD for Lewy body Screening scale in Cognitive Disorders.

Methods: 128 patients who fulfilled the clinical criteria of dementia with Lewy bodies (DLB; n = 32), Alzheimer's disease (AD; n = 77) or both (n = 19) was prospectively enrolled. 18F-DOPA PET imaging and/or CSF biomarkers were available in some patients. LeSCoD scale was systematically administered and the potential correlation with 18F-DOPA PET imaging was evaluated in a subgroup of patients.

Results: LeSCoD scale showed robust internal and external validity. We determined a cut-off of 10 above which the sensitivity and specificity for Lewy body disease diagnosis were 86% and 95%, respectively. The LeSCoD scale correlated with striatal dopamine uptake in 18F-DOPA PET.

Conclusion: LeSCoD scale is a simple and reliable tool for the evaluation of Lewy body disease in routine clinical practice, with a higher sensitivity and specificity than the existing criteria. It might be an alternative to the use of dopamine-specific imaging.

Keywords: 18F-DOPA PET; Alzheimer’s disease; Dementia with Lewy bodies; Lewy body disease.

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