New Therapeutic Strategies for Lewy Body Dementias

TY - JOUR

T1 - New Therapeutic Strategies for Lewy Body Dementias

AU - Velayudhan, Latha

AU - Ffytche, Dominic

AU - Ballard, Clive

AU - Aarsland, Dag

PY - 2017/9

Y1 - 2017/9

N2 - This article reviews current treatment strategies and recent advances for the Lewy body dementias (LBDs). Current available symptom treatment strategies are based on monoaminergic, cholinergic and glutaminergic neurotransmitter systems. Relatively robust evidence exists for cholinesterase inhibitors for cognitive impairment in LBD and in Parkinson's disease for antidepressants, clozapine and recently pimavanserin for psychosis. interpidine (RVT 101) and nelotanserin are currently under investigation. Non-pharmacological interventions, such as cognitive stimulation, physical exercises and neuromodulation strategies, may be useful in Parkinson's disease but have not yet been tested in dementias. Disease-modifying approaches are aimed at preventing, slowing or ameliorating the production, aggregation and deposition of pathological proteins, including immunotherapy targeting α-synuclein and an ongoing trial using ambroxol which increases glucocerebrosidase activity to lower the levels of the protein alpha-synuclein. Other disease-modifying clinical trials are using agents to augment insulin signalling, stem cell therapy, reducing amyloid pathology and gene therapy.

AB - This article reviews current treatment strategies and recent advances for the Lewy body dementias (LBDs). Current available symptom treatment strategies are based on monoaminergic, cholinergic and glutaminergic neurotransmitter systems. Relatively robust evidence exists for cholinesterase inhibitors for cognitive impairment in LBD and in Parkinson's disease for antidepressants, clozapine and recently pimavanserin for psychosis. interpidine (RVT 101) and nelotanserin are currently under investigation. Non-pharmacological interventions, such as cognitive stimulation, physical exercises and neuromodulation strategies, may be useful in Parkinson's disease but have not yet been tested in dementias. Disease-modifying approaches are aimed at preventing, slowing or ameliorating the production, aggregation and deposition of pathological proteins, including immunotherapy targeting α-synuclein and an ongoing trial using ambroxol which increases glucocerebrosidase activity to lower the levels of the protein alpha-synuclein. Other disease-modifying clinical trials are using agents to augment insulin signalling, stem cell therapy, reducing amyloid pathology and gene therapy.

KW - Dementia with Lewy bodies

KW - Treatment

KW - Therapy

KW - alpha-synuclein

KW - Lewy body dementia

KW - Parkinson's disease

U2 - 10.1007/s11910-017-0778-2

DO - 10.1007/s11910-017-0778-2

M3 - Review article

C2 - 28741230

SN - 1528-4042

VL - 17

SP - 68

JO - CURRENT NEUROLOGY AND NEUROSCIENCE REPORTS

JF - CURRENT NEUROLOGY AND NEUROSCIENCE REPORTS

IS - 9

ER -