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Meta-Analysis
. 2023 Jul;19(7):3186-3202.
doi: 10.1002/alz.13105. Epub 2023 Apr 24.

Research diagnostic criteria for mild cognitive impairment with Lewy bodies: A systematic review and meta-analysis

Paul C Donaghy  1 , Claudia Carrarini  2   3 , Daniel Ferreira  4   5 , Annegret Habich  4   6 , Dag Aarsland  7   8 , Claudio Babiloni  9   10 , Ece Bayram  11 , Joseph Pm Kane  12 , Simon Jg Lewis  13 , Andrea Pilotto  14 , Alan J Thomas  1 , Laura Bonanni  15 ; Alzheimer's Association International Society to Advance Alzheimer's Research and Treatment Lewy Body Dementias Prodromal Working Group
Affiliations
Meta-Analysis

Research diagnostic criteria for mild cognitive impairment with Lewy bodies: A systematic review and meta-analysis

Paul C Donaghy et al. Alzheimers Dement. 2023 Jul.

Abstract

Introduction: Operationalized research criteria for mild cognitive impairment with Lewy bodies (MCI-LB) were published in 2020. The aim of this systematic review and meta-analysis was to review the evidence for the diagnostic clinical features and biomarkers in MCI-LB set out in the criteria.

Methods: MEDLINE, PubMed, and Embase were searched on 9/28/22 for relevant articles. Articles were included if they presented original data reporting the rates of diagnostic features in MCI-LB.

Results: Fifty-seven articles were included. The meta-analysis supported the inclusion of the current clinical features in the diagnostic criteria. Evidence for striatal dopaminergic imaging and meta-iodobenzylguanidine cardiac scintigraphy, though limited, supports their inclusion. Quantitative electroencephalogram (EEG) and fluorodeoxyglucose positron emission tomography (PET) show promise as diagnostic biomarkers.

Discussion: The available evidence largely supports the current diagnostic criteria for MCI-LB. Further evidence will help refine the diagnostic criteria and understand how best to apply them in clinical practice and research.

Highlights: A meta-analysis of the diagnostic features of MCI-LB was carried out. The four core clinical features were more common in MCI-LB than MCI-AD/stable MCI. Neuropsychiatric and autonomic features were also more common in MCI-LB. More evidence is needed for the proposed biomarkers. FDG-PET and quantitative EEG show promise as diagnostic biomarkers in MCI-LB.

Keywords: Lewy body disease; biomarkers; dementia with Lewy bodies; diagnosis; diagnostic criteria; electroencephalography; imaging; mild cognitive impairment; symptoms.

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Conflict of interest statement

CONFLICT OF INTEREST STATEMENT

Paul C Donaghy has received grant funding from the Medical Research Council, Alzheimer’s Society, Alzheimer’s Research UK and the Lewy Body Society. He has received honoraria (paid to institution) for educational presentations for the Neurology Academy.

Claudia Carrarini has no competing interests.

Daniel Ferreira has no competing interests.

Dag Aarsland has received research support and/or honoraria from Astra-Zeneca, H. Lundbeck, Novartis Pharmaceuticals, Evonik, Daily Color, Roche Diagnostics, and GE Health, and served as paid consultant for H. Lundbeck, Eisai, Heptares, Mentis Cura, Eli Lilly, Cognetivity, Enterin, Acadia, EIP Pharma, and Biogen.

Claudio Babiloni is Immediate Past Chair (2021–2023) of the ISTAART Electrophysiology Professional Interest Area.

Ece Bayram receives research support from the National Institutes of Health (K99AG073453, U01NS119562).

Joseph PM Kane has received honoraria for educational presentations for the Neurology Academy. He has received grant funding from the Lewy Body Society and Alzheimer’s Research UK. He is a director of Lewy Body Ireland CLG, a non-profit organisation in the process of applying for charity status, for which he receives no remuneration.

Simon JG Lewis has no competing interests.

Annegret Habich has no competing interests.

Andrea Pilotto has no competing interests.

Alan J Thomas has received support from GE Healthcare for investigator-led research including the provision of 123I-FP-CIT. He has also received research grant funding from dementia charities for work on MCI.

Laura Bonanni has received research grant support by the Italian ministry of health and is a national board member of a project promoted by PIAM on MCI diagnosis among the dementia centres. She also received research grant support for the application of a diagnostic algorithm for MCI diagnosis. Author disclosures are available in the supporting information.

Figures

FIGURE 1
FIGURE 1
PRISMA flow diagram.
See this image and copyright information in PMC

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