In a behavioral study of 24 prodromal/mild DLB patients vs 24 matched controls, patients showed impaired facial emotion recognition and higher alexithymia, depression, and anxiety scores.

While not mechanistic, the identification of early emotional disturbances in prodromal DLB could inform clinical recognition of synuclein-related prodromal states and guide early symptomatic management or stratification in PD-spectrum research.

BackgroundA growing body of literature has documented emotional disorders in patients with dementia with Lewy bodies (DLB). While emotional symptoms have been well studied in Alzheimer's disease (AD) and Parkinson's disease (PD), no study to date has provided a comprehensive overview of emotional disturbances specifically associated with DLB.ObjectiveThis study aimed to investigate the emotional profile of patients with prodromal or mild DLB compared to healthy controls.MethodsBehavioral data were collected from 24 prodromal or mild DLB patients, and 24 healthy participants, matched for age, gender and educational level. Statistics, including group comparisons and correlation analyses, were conducted using the following measures: the Florida Affect Battery (FAB), the 20-item Toronto Alexithymia Scale (TAS-20), the Echelle d'Humeur Depressive (EHD), and the Generalized Anxiety Disorder 7-item (GAD-7) scale.ResultsPatients with DLB demonstrated significantly impaired performance on the FAB alongside elevated scores on the TAS-20, the EHD, and the GAD-7 compared to controls.ConclusionsThese findings highlight profound disruptions in internal emotional experience among patients with prodromal or mild DLB, notably marked by elevated alexithymic traits, altered emotional expression, emotional dyscontrol, anxiety, and impairments in automatic and implicit recognition of facial emotions. Our study supports the critical need for early detection, systematic evaluation, and personalized management of emotional symptoms through targeted interventions.