LEWY-BODY DEMENTIA AND RESPONSIVENESS TO CHOLINESTERASE-INHIBITORS - A PARADIGM FOR HETEROGENEITY OF ALZHEIMERS-DISEASE

The concept of heterogeneity of Alzheimer's disease is based on molecu lar, neuropathological, clinical and neuropsychological features, and also supported by the observation that Alzheimer's patients differ in their response to pharmacological interventions. Recent investigations evaluating the therapeutic potential of cholinesterase inhibitors hav e disclosed the existence of at least two subsets of patients with dem entia, defined as 'responders' and 'nonresponders' to this therapy. In this article, Paolo Liberini and colleagues suggest that the cluster of responders to the cholinesterase inhibitors might include a signifi cant number of subjects with a rather selective dysfunction of the cho linergic system, as in the case of Lewy-body dementia. A neuropatholog ical demonstration of this correlation should open up new therapeutic perspectives.