O papel dos biomarcadores recentes no diagnóstico precoce da demência por corpos de Lewy

Rhafael Tobias  Bastos; Iuri Cesar  Lima Paiva; Eberson  da Silva Rodrigues Nascimento

Authors

Rhafael Tobias Bastos Graduando em Medicina na Universidade Federal de Goiás UFG, Goiânia/GO, Brasi Autor https://orcid.org/0009-0006-7522-8757
Iuri Cesar Lima Paiva Graduando em Medicina na Universidade Federal de Goiás UFG, Goiânia/GO, Brasi Autor https://orcid.org/0009-0006-0205-1399
Eberson da Silva Rodrigues Nascimento Graduado em Medicina pela Universidade Federal de Goiás UFG, Goiânia/GO, Brasil. Autor https://orcid.org/0000-0001-7728-3633

Keywords:

Alpha-synuclein, Dementia with Lewy Bodies, Early diagnosis, Fluid biomarkers, Molecular imaging

Abstract

Dementia with Lewy Bodies is one of the most challenging neurodegenerative conditions in older adults, frequently underdiagnosed due to its phenotypic overlap with Alzheimer’s disease and Parkinson’s disease. This study synthesizes the primary molecular, imaging, and neurophysiological biomarkers that enable the early detection and pathological differentiation of this condition during prodromal phases. Through a critical review of contemporary biological consensus criteria, the disruptive role of Alpha-Synuclein Seed Amplification Assays in cerebrospinal fluid and peripheral tissues is analyzed, showcasing high diagnostic specificity in vivo. Additionally, the contribution of iodine-123-metaiodobenzylguanidine. myocardial scintigraphy in identifying postganglionic sympathetic denervation and dopamine transporter imaging in evaluating striatal neuronal loss is examined. In the neurophysiological spectrum, the value of quantitative electroencephalography in identifying the slowing of posterior background activity is highlighted, correlating with characteristic cognitive fluctuations. It is established that transitioning from a purely clinical diagnostic model to an integrated bio-clinical approach is essential for identifying the disease in its earliest stages. This advancement facilitates the timely enrollment of patients in clinical trials for disease-modifying therapies and optimizes early, targeted therapeutic management.

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