Article Document Information Content Entity Continuant Continuant Entity Entity Review Generically Dependent Continuant 2025-05-07T20:53:16 RDF description of Dementia with Lewy bodies: impact of co-pathologies and implications for clinical trial design [review] - http://repository.healthpartners.com/individual/document-rn31945 Alzheimer's Disease review Dementia with Lewy bodies: impact of co-pathologies and implications for clinical trial design [review] 20920 35880 Cross-Sectional Studies public 1 Alzheimer's & dementia 2023-03-02T21:31:05.278-06:00 Clinical Trials 10.1002/alz.12814 19 Research Design Biomarkers <p>Dementia with Lewy bodies (DLB) is clinically defined by the presence of visual hallucinations, fluctuations, rapid eye movement (REM) sleep behavioral disorder, and parkinsonism. Neuropathologically, it is characterized by the presence of Lewy pathology. However, neuropathological studies have demonstrated the high prevalence of coexistent Alzheimer's disease, TAR DNA-binding protein 43 (TDP-43), and cerebrovascular pathologic cases. Due to their high prevalence and clinical impact on DLB individuals, clinical trials should account for these co-pathologies in their design and selection and the interpretation of biomarkers values and outcomes. Here we discuss the frequency of the different co-pathologies in DLB and their cross-sectional and longitudinal clinical impact. We then evaluate the utility and possible applications of disease-specific and disease-nonspecific biomarkers and how co-pathologies can impact these biomarkers. We propose a framework for integrating multi-modal biomarker fingerprints and step-wise selection and assessment of DLB individuals for clinical trials, monitoring target engagement, and interpreting outcomes in the setting of co-pathologies.<p> document-rn31945 Parkinson Disease