DLB Cognitive Fluctuation Mechanism Experiment

SUMMARY

# DLB Cognitive Fluctuation Mechanism Experiment ## Background and Rationale Dementia with Lewy Bodies (DLB) represents the second most common form of neurodegenerative dementia after Alzheimer's disease, yet its pathophysiological mechanisms remain poorly understood compared to other neurodegenerative disorders. The hallmark cognitive fluctuations that characterize DLB—dramatic variations in attention, alertness, and executive function occurring over minutes to hours—present a unique window int

METHODOLOGY NOTES

**Phase 1: Patient Recruitment and Baseline Assessment (Weeks 1-8)** • Recruit 120 participants: 40 DLB patients (meeting consensus criteria), 40 Parkinson's disease patients, 40 age-matched healthy controls • Obtain informed consent and conduct comprehensive neurological examination • Administer standardized cognitive assessments: Montreal Cognitive Assessment (MoCA), Unified Parkinson's Disease Rating Scale (UPDRS), Clinician Assessment of Fluctuation (CAF) • Collect baseline CSF samples (10mL) for α-synuclein, tau, and Aβ42 analysis via lumbar puncture • Perform structural MRI and resting-state fMRI on 3T scanner with standardized protocols **Phase 2: Real-time Fluctuation Monitoring (Weeks 9-20)** • Deploy continuous monitoring using wearable EEG devices (64-channel) for 7-day periods per participant • Conduct hourly cognitive assessments using tablet-based attention and executive function tasks • Monitor autonomic function via heart rate variability, blood pressure, and skin cond