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An unusual delusion of duplication in a patient affected by Dementia with Lewy bodies.

Abstract Dementia with Lewy bodies (DLB) is the second most frequent diagnosis of progressive degenerative dementia in older people. Delusions are common features in DLB and, among them, Capgras syndrome represents the most frequent disturbance, characterized by the recurrent and transient belief that a familiar person, often a close family member or caregiver, has been replaced by an identical-looking imposter. However, other delusional conditions near to misidentification syndromes can occur in DLB patients and may represent a major psychiatric disorder, although rarely studied systematically.
PMID
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Authors

Mayor MeshTerms
Keywords

Capgras syndrome

Delusion of duplication

Dementia with Lewy bodies

Misidentification syndromes

Journal Title bmc neurology
Publication Year Start




PMID- 28424054
OWN - NLM
STAT- MEDLINE
DA  - 20170420
DCOM- 20170515
LR  - 20170515
IS  - 1471-2377 (Electronic)
IS  - 1471-2377 (Linking)
VI  - 17
IP  - 1
DP  - 2017 Apr 19
TI  - An unusual delusion of duplication in a patient affected by Dementia with Lewy
      bodies.
PG  - 78
LID - 10.1186/s12883-017-0842-1 [doi]
AB  - BACKGROUND: Dementia with Lewy bodies (DLB) is the second most frequent diagnosis
      of progressive degenerative dementia in older people. Delusions are common
      features in DLB and, among them, Capgras syndrome represents the most frequent
      disturbance, characterized by the recurrent and transient belief that a familiar 
      person, often a close family member or caregiver, has been replaced by an
      identical-looking imposter. However, other delusional conditions near to
      misidentification syndromes can occur in DLB patients and may represent a major
      psychiatric disorder, although rarely studied systematically. CASE PRESENTATION: 
      We reported on a female patient affected by DLB who presented with an unusual
      delusion of duplication. Referring to the female professional caregiver engaged
      by her relatives for her care, the patient constantly described the presence of
      two different female persons, with a disorder framed in the context of a delusion
      of duplication. A brain 99Tc-hexamethylpropyleneamineoxime SPECT was performed
      showing moderate hypoperfusion in both occipital lobes, and associated with
      marked decreased perfusion in parieto-fronto-temporal lobes bilaterally.
      CONCLUSIONS: An occipital hypoperfusion was identified, although in association
      with a marked global decrease of perfusion in the remaining lobes. The role of
      posterior lobes is certainly important in all misidentification syndromes where a
      natural dissociation between recognition and identification is present. Moreover,
      the concomitant presence of severe attentional and executive deficits evocative
      for a frontal syndrome and the marked global decrease of perfusion in the
      remaining lobes at the SPECT scan also suggest a possible dysfunction in an
      abnormal connectivity between anterior and posterior areas.
FAU - Solla, Paolo
AU  - Solla P
AUID- ORCID: http://orcid.org/0000-0002-2982-0665
AD  - Department of Neurology, Movement Disorders Center, Institute of Neurology,
      University of Cagliari, SS 554 Bivio per Sestu, Monserrato, 09042, Cagliari,
      Italy. [email protected]
FAU - Mura, Gioia
AU  - Mura G
AD  - Department of Medical Sciences and Public Health, University of Cagliari,
      Cagliari, Italy.
FAU - Cannas, Antonino
AU  - Cannas A
AD  - Department of Neurology, Movement Disorders Center, Institute of Neurology,
      University of Cagliari, SS 554 Bivio per Sestu, Monserrato, 09042, Cagliari,
      Italy.
FAU - Floris, Gianluca
AU  - Floris G
AD  - Department of Neurology, Movement Disorders Center, Institute of Neurology,
      University of Cagliari, SS 554 Bivio per Sestu, Monserrato, 09042, Cagliari,
      Italy.
FAU - Fonti, Davide
AU  - Fonti D
AD  - Department of Neurology, Movement Disorders Center, Institute of Neurology,
      University of Cagliari, SS 554 Bivio per Sestu, Monserrato, 09042, Cagliari,
      Italy.
FAU - Orofino, Gianni
AU  - Orofino G
AD  - Department of Neurology, Movement Disorders Center, Institute of Neurology,
      University of Cagliari, SS 554 Bivio per Sestu, Monserrato, 09042, Cagliari,
      Italy.
FAU - Carta, Mauro Giovanni
AU  - Carta MG
AD  - Chair of Quality of Care and Applied Medical Technologies, Department of Public
      Health, Clinical and Molecular Medicine, University of Cagliari, Monserrato,
      Italy.
FAU - Marrosu, Francesco
AU  - Marrosu F
AD  - Department of Neurology, Movement Disorders Center, Institute of Neurology,
      University of Cagliari, SS 554 Bivio per Sestu, Monserrato, 09042, Cagliari,
      Italy.
AD  - Department of Medical Sciences and Public Health, University of Cagliari,
      Cagliari, Italy.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20170419
PL  - England
TA  - BMC Neurol
JT  - BMC neurology
JID - 100968555
RN  - 0 (Oximes)
RN  - 0 (Technetium Compounds)
RN  - 0 (hexamethylpropyleneamine oxime)
SB  - IM
MH  - Aged
MH  - Capgras Syndrome/*complications
MH  - Cerebral Cortex/blood supply
MH  - Female
MH  - Humans
MH  - Lewy Body Disease/complications/*psychology
MH  - Neuroimaging
MH  - Oximes/metabolism
MH  - Technetium Compounds/metabolism
MH  - Tomography, Emission-Computed, Single-Photon
PMC - PMC5395768
OTO - NOTNLM
OT  - *Capgras syndrome
OT  - *Delusion of duplication
OT  - *Dementia with Lewy bodies
OT  - *Misidentification syndromes
EDAT- 2017/04/21 06:00
MHDA- 2017/05/16 06:00
CRDT- 2017/04/21 06:00
PHST- 2016/07/04 [received]
PHST- 2017/03/17 [accepted]
AID - 10.1186/s12883-017-0842-1 [doi]
AID - 10.1186/s12883-017-0842-1 [pii]
PST - epublish
SO  - BMC Neurol. 2017 Apr 19;17(1):78. doi: 10.1186/s12883-017-0842-1.

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