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Nickhah Klashami Z, Yaghoobi A, Panahi N, Amoli MM. Association of the APOE gene variants with depression in type 2 diabetes. J Diabetes Metab Disord 2023; 22:1481-1487. [PMID: 37975117 PMCID: PMC10638337 DOI: 10.1007/s40200-023-01271-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 07/27/2023] [Indexed: 11/19/2023]
Abstract
Background The risk of depression among patients with diabetes is higher than the general population. The exact mechanisms linking these two diseases are mostly unknown. Energy metabolism disorders seem to be a shared pathway. One of the key genes playing important roles in energy metabolism-related pathways is the APOE gene. We aimed to investigate the association of the APOE gene variants with depression among Iranian patients with type 2 diabetes (T2DM). Methods Three APOE gene alleles and genotypes frequencies (E2, E3, E4) were determined in 244 patients with T2DM (114 with depression and 130 without depression) using the high-resolution melting (HRM) method on the genomic DNA extracted from the patient's peripheral blood. Results Apoe4 allele frequency was significantly higher in T2DM patients without depression compared with those with depression (11.9 vs. 2.2%, p-value < 0.0001 and p-value = 0.001, respectively). Conversely, the wild allele apoe3 frequency was significantly higher in T2DM patients with depression (86% vs., 69%, p-value < 0.0001). Apoe4 carrier status was associated with decreased risk of depression in patients with T2DM [OR: 0.19 (0.07-0.53)]. Conclusion Our results showed that the apoe4 allele and apoe4 carrier status significantly reduced the risk of depression among patients with T2DM. Further studies are needed to unravel the complex role of the APOE gene in depression among patients with diabetes.
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Affiliation(s)
- Zeynab Nickhah Klashami
- Metabolic Disorders Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Yaghoobi
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nekoo Panahi
- Metabolic Disorders Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahsa M. Amoli
- Metabolic Disorders Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Lavie I, Beeri MS, Berman Y, Schwartz Y, Soleimani L, Heymann A, Ravona-Springer R. Trajectories of depression symptoms over time differ by APOE4 genotype in older adults with type 2 diabetes. Int J Geriatr Psychiatry 2021; 36:1567-1575. [PMID: 34010987 PMCID: PMC8845090 DOI: 10.1002/gps.5583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 05/17/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVES The APOE-ε4 genotype has been associated with old-age depression, but this relationship has been rarely investigated in type 2 diabetes (T2D) older adults, who are at significantly increased risk for depression, a major contributor to T2D complications. We examined whether trajectories of depression symptoms over time differ by APOE-ε4 genotype in older adults with T2D. METHODS Participants (n = 754 [13.1% APOE-ε4 carrier]s) were from the longitudinal Israel Diabetes and Cognitive Decline (IDCD) study. They were initially cognitively normal and underwent evaluations of depression approximately every 18 months using the 15-item version of the Geriatric Depression Scale (GDS) and the depression subscale of the Neuropsychiatric Inventory (NPI). APOE was defined as a dichotomy of ε4 carriers and non-carriers. We used Hierarchical Linear Mixed Models (HLMM) that modeled the effects of APOE status on repeated GDS and NPI-depression scores in an unadjusted model (Model 1), adjusting for demographic factors (Model 2) and additionally adjusting for cardiovascular factors and global cognition (Model 3). RESULTS Participants' mean age was 71.37 (SD = 4.5); 38.2% female. In comparison to non-carriers, APOE-ε4 carriers had lower mean GDS scores (β = -0.46, p = 0.018) and lower NPI-depression scores (β = -0.170, p = 0.038) throughout all study follow period. The groups did not differ in the slope of change over time in GDS (β = -0.005, p = 0.252) or NPI-depression (β = -0.001, p = 0.994) scores. Additional adjustment for cardiovascular factors and global cognition did not alter these results. CONCLUSIONS In older adults with T2D, APOE-ε4 carriers have less depressive symptoms in successive measurements suggesting they may be less susceptible to depression.
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Affiliation(s)
- Inbar Lavie
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Michal Schnaider Beeri
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel,The Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA,Baruch Ivcher School of Psychology, Interdisciplinary Center, Herzliya, Israel
| | - Yuval Berman
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Yonathan Schwartz
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Laili Soleimani
- The Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Anthony Heymann
- Department of Family Medicine, Tel Aviv University, Tel Aviv, Israel,Maccabi Health Services, Tel Aviv, Israel
| | - Ramit Ravona-Springer
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel,The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel,Psychiatric Division, Sheba Medical Center, Tel-Hashomer, Israel
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Banning LCP, Ramakers IHGB, Deckers K, Verhey FRJ, Aalten P. Apolipoprotein E and affective symptoms in mild cognitive impairment and Alzheimer's disease dementia: A systematic review and meta-analysis. Neurosci Biobehav Rev 2018; 96:302-315. [PMID: 30513312 DOI: 10.1016/j.neubiorev.2018.11.020] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 10/24/2018] [Accepted: 11/30/2018] [Indexed: 01/17/2023]
Abstract
OBJECTIVE APOE status has been associated to affective symptoms in cognitively impaired subjects, with conflicting results. METHODS Databases CINAHL, Embase, PsychINFO and PubMed were searched for studies evaluating APOE genotype with affective symptoms in MCI and AD dementia. Symptoms were meta-analyzed separately and possible sources of heterogeneity were examined. RESULTS Fifty-three abstracts fulfilled the eligibility criteria. No association was found between the individual symptoms and APOE ε4 carriership or zygosity. For depression and anxiety, only pooled unadjusted estimates showed positive associations with between-study heterogeneity, which could be explained by variation in study design, setting and way of symptom assessment. CONCLUSIONS There is no evidence that APOE ε4 carriership or zygosity is associated with the presence of depression, anxiety, apathy, agitation, irritability or sleep disturbances in cognitively impaired subjects. Future research should shift its focus from this single polymorphism to a more integrated view of other biological factors.
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Affiliation(s)
- Leonie C P Banning
- Alzheimer Center Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands.
| | - Inez H G B Ramakers
- Alzheimer Center Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands.
| | - Kay Deckers
- Alzheimer Center Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands.
| | - Frans R J Verhey
- Alzheimer Center Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands.
| | - Pauline Aalten
- Alzheimer Center Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands.
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4
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Qian W, Fischer CE, Schweizer TA, Munoz DG. Association Between Psychosis Phenotype and APOE Genotype on the Clinical Profiles of Alzheimer's Disease. Curr Alzheimer Res 2018; 15:187-194. [PMID: 28847281 PMCID: PMC6211852 DOI: 10.2174/1567205014666170829114346] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 07/07/2017] [Accepted: 08/29/2017] [Indexed: 12/26/2022]
Abstract
BACKGROUND Psychosis is a common phenomenon in Alzheimer's disease (AD). The APOE ε4 allele is the strongest genetic risk factor for the development of AD, but its association with psychosis remains unclear. OBJECTIVE We investigated the associations between psychosis, subdivided into delusions and hallucinations, as well as APOE ε4 allele on cognitive and functional outcomes. Secondarily, we investigated the associations between APOE ε4, Lewy bodies, and psychosis. METHODS Data from the National Alzheimer's Coordinating Center (NACC) were used. Nine hundred patients with a confirmed diagnosis of AD based on the NIA-AA Reagan were included in the analysis. Global cognition was assessed using the Mini-Mental State Exam (MMSE) and functional status was assessed using the Functional Activities Questionnaire (FAQ). Psychosis status was determined using the Neuropsychiatric Inventory Questionnaire (NPI-Q). Factorial design was used to assess the effects of psychosis and APOE ε4, as well as their interaction. RESULTS Psychosis and the presence of APOE ε4 were both associated with lower MMSE scores, while only psychosis was associated with higher FAQ scores. Furthermore, patients with hallucinations had lower MMSE and higher FAQ scores than patients with only delusions. There was a significant interaction effect between psychosis and APOE ε4 on MMSE scores, with APOE ε4 negatively affecting patients with hallucinations-only psychosis. APOE ε4 was positively associated with the presence of Lewy body pathology, and both were found to be more prevalent in psychotic patients, with a stronger association with hallucinations. CONCLUSION Psychosis in AD was associated with greater cognitive and functional impairments. Patients with hallucinations-with or without delusions-conferred even greater deficits compared to patients with only delusions. The APOE ε4 allele was associated with worse cognition, especially for patients with hallucination-only psychosis. APOE ε4 may mediate cognitive impairment in the hallucinations phenotype through the development of Lewy bodies. Our findings support that subtypes of psychosis should be evaluated separately.
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Affiliation(s)
- Winnie Qian
- Keenan Research Centre for Biomedical Research, The Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
| | - Corinne E. Fischer
- Keenan Research Centre for Biomedical Research, The Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
- Faculty of Medicine, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Tom A. Schweizer
- Keenan Research Centre for Biomedical Research, The Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, University of Toronto, ON, Canada
- Division of Neurosurgery, St. Michael’s Hospital, Toronto, ON, Canada
| | - David G. Munoz
- Keenan Research Centre for Biomedical Research, The Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
- Division of Pathology, St. Michael’s Hospital, Toronto, ON, Canada
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5
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Park S, Nam YY, Sim Y, Hong JP. Interactions between the apolipoprotein E ε4 allele status and adverse childhood experiences on depressive symptoms in older adults. Eur J Psychotraumatol 2015; 6:25178. [PMID: 25630472 PMCID: PMC4309830 DOI: 10.3402/ejpt.v6.25178] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Revised: 12/05/2014] [Accepted: 12/08/2014] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The influence of childhood adversity on depression is modulated by genetic vulnerability. The apolipoprotein E ε4 (APOE-ε4) allele is a strong genetic risk factor for Alzheimer's disease (AD). Because late-life depressive symptoms could be a part of the preclinical course of AD, the APOE-ε4 allele may contribute to depression in old age. OBJECTIVE The aim of this study was to evaluate whether an APOE-ε4 carrier status was associated with depressive symptoms in older adults and to detect the gene-environment interaction between APOE-ε4 status and childhood adversity in relation to depressive symptoms in old age. METHOD The participants consisted of 137 older adults (age range 50-70) without any psychiatric history or clinically significant cognitive impairment. APOE genotypes and measures of childhood adversity and depressive symptoms were obtained. RESULTS There was a significant positive association between adverse childhood experiences (ACE) scores and depressive symptoms (B=0.60; 95% CI=0.26, 0.93 for a 1 score increase in ACE scores; p=0.001). Although APOE-ε4 status per se was not associated with depressive symptoms, there was a significant interaction of the ACE scores with the APOE genotype in relation to depressive symptoms (B=0.78; 95% CI=0.02, 1.55; p=0.044). There was a significantly higher effect of childhood adversity on depressive symptoms in APOE-ε4 carriers than non-carriers (t=2.13, p=0.035). CONCLUSIONS Our results suggest that the APOE-ε4 may modulate the association between childhood adversity and depressive symptoms in older adults. However, more research in a larger sample is needed to gain a better understanding of the relationship between the APOE-ε4, childhood adversity, and depression.
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Affiliation(s)
- Subin Park
- Department of Psychiatry, Seoul National Hospital, Seoul, South Korea
| | - Yoon-Young Nam
- Department of Psychiatry, Seoul National Hospital, Seoul, South Korea
| | - Yoojin Sim
- Department of Psychiatry, Asan Medical Center, Ulsan University College of Medicine, Seoul, South Korea
| | - Jin Pyo Hong
- Department of Psychiatry, Samsung Medical Center, Seoul, South Korea;
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Proitsi P, Powell JF. Missense substitutions associated with behavioural disturbances in Alzheimer's disease (AD). Brain Res Bull 2012; 88:394-405. [PMID: 22414959 DOI: 10.1016/j.brainresbull.2012.02.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2011] [Revised: 02/03/2012] [Accepted: 02/24/2012] [Indexed: 11/18/2022]
Abstract
Behavioural and psychological symptoms in dementia, or BPSD, occur in the majority of Alzheimer's disease (AD) patients. They are associated with considerable patient morbidity and greater care-giver stress. There is some evidence suggesting that BPSD have a genetic component and a large number of studies have examined the association of candidate genes with these symptoms. This review provides a comprehensive summary of all the published studies investigating the association of candidate gene missense substitutions with BPSD. Missense substitutions could potentially alter protein function or render the protein non-functional, resulting in phenotypic consequences. More than 80 studies investigating the association of 8 missense substitutions in 7 genes with BPSD were identified. However, results of these studies are contradictory and do not provide firm support for these associations. Larger studies and more systematic approaches will delineate the association of missense substitutions with behavioural symptoms in AD.
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Affiliation(s)
- Petroula Proitsi
- King's College London, Institute of Psychiatry, Department of Neuroscience, De Crespigny Park, London SE5 8AF, UK.
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7
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Panza F, Frisardi V, Seripa D, D'Onofrio G, Santamato A, Masullo C, Logroscino G, Solfrizzi V, Pilotto A. Apolipoprotein E genotypes and neuropsychiatric symptoms and syndromes in late-onset Alzheimer's disease. Ageing Res Rev 2012; 11:87-103. [PMID: 21763789 DOI: 10.1016/j.arr.2011.06.005] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2010] [Revised: 05/29/2011] [Accepted: 06/30/2011] [Indexed: 12/31/2022]
Abstract
Neuropsychiatric symptoms (NPS) in dementia, previously denominated as behavioural and psychological symptoms of dementia, are often more distressing, impairing, and costly than cognitive symptoms, representing a major health burden for older adults. These symptoms are common features of Alzheimer's disease (AD), and are one of the major risk factors for institutionalization. There is a high prevalence of neuropsychiatric disturbances in patients with AD, including depression, anxiety, apathy, psychosis, aggression, and agitation. At present, the role of the apolipoprotein E (APOE) genotypes in the development of NPS or neuropsychiatric syndromes/endophenotypes in AD patients is unclear. In this article, we summarized the findings of the studies of NPS and neuropsychiatric syndromes in AD in relation to APOE genotypes, with special attention to the possible underlying mechanisms. While some studies failed to find a significant association between the APOE polymorphism and NPS in late-onset AD, other studies reported a significant association between the APOE ɛ4 allele and an increase in agitation/aggression, hallucinations, delusions, and late-life depression or anxiety. However, current cumulative evidence coming from the few existing longitudinal studies shows no association of APOE genotypes with NPS as a whole in AD. Some negative studies that focused on the distribution of APOE genotypes between AD patients with or without NPS further emphasized the importance of sub-grouping NPS in distinct neuropsychiatric syndromes. Explanations for the variable findings in the existing studies included differences in patient populations, differences in the assessment of neuropsychiatric symptomatology, possible lack of statistical power to detect associations in the negative studies, and small sample sizes generating false positives that cannot be consistently replicated. Finally, many reviewed studies were cross-sectional, whereas it would be of paramount importance to evaluate the risk for incident NPS in relation to the APOE genotype in prospectively followed cohorts of AD patients. In fact, identifying predisposing genetic risk factors may allow us to understand the pathophysiological features of neuropsychiatric syndromes or symptoms in AD, so optimizing possible therapeutic options.
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Affiliation(s)
- Francesco Panza
- Geriatric Unit & Gerontology-Geriatrics Research Laboratory, Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy.
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8
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D'Onofrio G, Panza F, Seripa D, Sancarlo D, Paris F, Cascavilla L, Urbano M, Gravina C, Fontana A, Solfrizzi V, Pellegrini F, Pilotto A. The APOE polymorphism in Alzheimer's disease patients with neuropsychiatric symptoms and syndromes. Int J Geriatr Psychiatry 2011; 26:1062-70. [PMID: 21905100 DOI: 10.1002/gps.2644] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2010] [Accepted: 09/03/2010] [Indexed: 11/07/2022]
Abstract
BACKGROUND Neuropsychiatric symptoms (NPS) are a common feature of Alzheimer's disease (AD), resulting in particular AD endophenotypes. The common AD genetic risk factor apolipoprotein E (APOE) has been suggested underlying these AD endophenotypes. METHODS APOE genotyping, a comprehensive geriatric assessment (CGA), and Neuropsychiatric Inventory were performed on 322 consecutive older patients. Patients were divided into three groups: AD with NPS (N = 93), AD without NPS (N = 108), and, as a control group, patients with no cognitive impairment (NoCI: N = 121). Patients with NPS were further sub-divided in four groups according to the European Alzheimer's Disease Consortium (EADC) classification of neuropsychiatric syndromes in AD: hyperactive, psychotic, affective, and apathetic. RESULTS AD patients with NPS showed a significantly higher grade of cognitive impairment, more severity stage of dementia, more disability in the activities of daily living (ADL), and the instrumental ADL than AD patients without NPS. As expected, an higher frequency of APOE ε3/ε4 genotype was observed in patients with AD, both with and without NPS, than patients with NoCI. No difference in the distribution of APOE genotypes was found between AD patients with vs. without NPS. However, in AD patients APOE ε4-carriers, there was an increased risk of affective [odds ratio (OR): 2.34, 95% confidence interval (CI): 1.19-4.58) and apathetic (OR: 2.24,95%CI: 1.19-4.22) syndromes. CONCLUSIONS These findings did not suggest a significant association between APOE polymorphism and presence of NPS in AD patients. In AD patients with NPS, however, APOE ε4-carrier status was associated with an increased risk of affective and apathetic syndromes.
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Affiliation(s)
- Grazia D'Onofrio
- Geriatrics Unit and Gerontology-Geriatric Research Laboratory, Department of Medical Sciences, IRCCS 'Casa Sollievo della Sofferenza', San Giovanni Rotondo, FG, Italy
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9
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Panza F, Seripa D, D'Onofrio G, Frisardi V, Solfrizzi V, Mecocci P, Pilotto A. Neuropsychiatric Symptoms, Endophenotypes, and Syndromes in Late-Onset Alzheimer's Disease: Focus on APOE Gene. Int J Alzheimers Dis 2011; 2011:721457. [PMID: 21559196 PMCID: PMC3090058 DOI: 10.4061/2011/721457] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2010] [Revised: 02/11/2011] [Accepted: 02/11/2011] [Indexed: 01/31/2023] Open
Abstract
Neuropsychiatric symptoms, previously denominated as behavioural and psychological symptoms of dementia, are common features of Alzheimer's disease (AD) and are one of the major risk factors for institutionalization. At present, the role of the apolipoprotein E (APOE) gene in the development of neuropsychiatric symptoms in AD patients is unclear. In this paper, we summarized the findings of the studies of neuropsychiatric symptoms and neuropsychiatric syndromes/endophenotypes in AD in relation to APOE genotypes, with special attention to the possible underlying mechanisms. While some studies failed to find a significant association between APOE and neuropsychiatric symptoms in late-onset AD, other studies reported a significant association between the APOE ε4 allele and an increase in agitation/aggression, hallucinations, delusions, and late-life depression or anxiety. Furthermore, some negative studies that focused on the distribution of APOE genotypes between AD patients with or without neuropsychiatric symptoms further emphasized the importance of subgrouping neuropsychiatric symptoms in distinct neuropsychiatric syndromes. Explanations for the variable findings in the existing studies included differences in patient populations, differences in the assessment of neuropsychiatric symptomatology, and possible lack of statistical power to detect associations in the negative studies.
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Affiliation(s)
- Francesco Panza
- Geriatric Unit and Gerontology-Geriatrics Research Laboratory, Department of Medical Sciences, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, 71013 Foggia, Italy
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10
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Flirski M, Sobow T, Kloszewska I. Behavioural genetics of Alzheimer's disease: a comprehensive review. Arch Med Sci 2011; 7:195-210. [PMID: 22291757 PMCID: PMC3258720 DOI: 10.5114/aoms.2011.22068] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2010] [Revised: 07/12/2010] [Accepted: 08/24/2010] [Indexed: 12/16/2022] Open
Abstract
Behavioural and psychological symptoms of dementia (BPSD) are present in the course of the illness in up to 90% of patients with Alzheimer's disease (AD). They are the main source of caregiver burden and one of the major factors contributing to early institutionalization. The involvement of a genetic component in BPSD aetiology seems beyond controversy, though the exact significance of particular polymorphisms is uncertain in the majority of cases. Multiple genes have been assessed for their putative influence on BPSD risk. In this paper we review the behavioural genetics of AD, particularly the importance, with respect to BPSD risk, of genes coding for apolipoprotein E and proteins involved in the process of neurotransmission: serotonin receptors, serotonin transporter, COMT, MAO-A, tryptophan hydroxylase and dopamine receptors. A general conclusion is the striking inconsistency of the findings, unsurprising in the field of psychiatric genetics. The potential reasons for such discrepancy are exhaustively discussed.
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Affiliation(s)
- Marcin Flirski
- Department of Old Age Psychiatry and Psychotic Disorders, Medical University of Lodz, Poland
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11
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Slifer MA, Martin ER, Gilbert JR, Haines JL, Pericak-Vance MA. Resolving the relationship between ApolipoproteinE and depression. Neurosci Lett 2009; 455:116-9. [PMID: 19368858 DOI: 10.1016/j.neulet.2009.03.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2008] [Revised: 02/15/2009] [Accepted: 03/03/2009] [Indexed: 11/17/2022]
Abstract
Several studies have reported an association between the ApolipoproteinE-epsilon4 (APOE4) allele and depression among elders. However others have failed to find an association. Since APOE4 is a well recognized risk factor for Alzheimer dementia, cognitive status may represent an important confounder between APOE4 and depression. In this investigation, we examined the relationship between the ApolipoproteinE-epsilon4 allele and depression among elders accounting for cognitive status. Using a case-control design (n=1052), we investigated the association between ApolipoproteinE-epsilon4 and depression in Alzheimer disease patients (n=528) and in cognitively intact controls (n=524). We demonstrated an apparent association between the APOE4 allele and depression in the combined dataset (p=0.001) when not controlling for cognitive status. However, once stratified by the presence of Alzheimer disease, there was no association in either the Alzheimer group (p=0.290) or the cognitively intact controls (p=0.494). In this dataset there is no association between the ApolipoproteinE-epsilon4 allele and depression among those with Alzheimer disease or among cognitively intact elders. However there is a significant association between female gender and depression in the cognitively intact (p=0.003) but not among those with Alzheimer disease. Additionally, individuals with Alzheimer disease and depression had a significantly younger age of onset for their Alzheimer disease than those without depression (p=0.017).
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Affiliation(s)
- Michael A Slifer
- Miami Institute for Human Genomics, University of Miami, Miami, FL 33136, USA.
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12
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Delano-Wood L, Houston WS, Emond JA, Marchant NL, Salmon DP, Thal LJ, Jeste DV, Bondi MW. APOE genotype predicts depression in women with Alzheimer's disease: a retrospective study. Int J Geriatr Psychiatry 2008; 23:632-6. [PMID: 18058831 PMCID: PMC2583456 DOI: 10.1002/gps.1953] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The association between the APOE epsilon4 allele and depression was investigated in a retrospective study of 323 AD patients. METHODS Patients were divided into demographically comparable groups based on the presence or absence of depression. RESULTS Results showed that the frequency of APOE epsilon4 allele was significantly higher in the depressed vs non-depressed AD patients (72% and 58%, respectively), and an interaction revealed that women possessing the APOE epsilon4 allele were almost four times more likely to be depressed than those without the epsilon4 allele. CONCLUSION Results are consistent with recent suggestions that the APOE epsilon4 genotype may be over-represented among depressed women with AD and highlight the need for additional research investigating the links between APOE genotype, mood, and gender.
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Affiliation(s)
| | - Wes S. Houston
- University of Iowa, Division of Cognitive Neuroscience, Department of Neurology
| | - Jennifer A. Emond
- University of California San Diego, School of Medicine, Department of Biostatistics
| | | | - David P. Salmon
- University of California San Diego, School of Medicine, Department of Neurosciences
| | - Leon J. Thal
- VA San Diego Healthcare System
- University of California San Diego, School of Medicine, Department of Neurosciences
| | - Dilip V. Jeste
- VA San Diego Healthcare System
- University of California San Diego, School of Medicine, Department of Psychiatry
- University of California San Diego, School of Medicine, Department of Neurosciences
| | - Mark W. Bondi
- VA San Diego Healthcare System
- University of California San Diego, School of Medicine, Department of Psychiatry
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13
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Ebmeier K. [The role of stress in the beginning of delayed and early depression in elderly subjects]. Encephale 2007; 32 Pt 4:S1095-8. [PMID: 17356474 DOI: 10.1016/s0013-7006(06)76291-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- K Ebmeier
- University of Edinburgh, Kennedy Tower, UK
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Pritchard AL, Harris J, Pritchard CW, Coates J, Haque S, Holder R, Bentham P, Lendon CL. The effect of the apolipoprotein E gene polymorphisms and haplotypes on behavioural and psychological symptoms in probable Alzheimer's disease. J Neurol Neurosurg Psychiatry 2007; 78:123-6. [PMID: 16980336 PMCID: PMC2077651 DOI: 10.1136/jnnp.2006.092122] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Patients with Alzheimer's disease and dementia commonly suffer from behavioural and psychological symptoms of dementia (BPSD). A genetic component to BPSD development in Alzheimer's disease has been demonstrated. Several studies have investigated whether the exon 4 epsilon2/epsilon3/epsilon4 haplotype of the apolipoprotein E (APOE) gene is associated with BPSD, with variable results. OBJECTIVE We investigated the exon 4 polymorphisms and extended this study to include promoter polymorphisms and the resultant haplotypes across the gene. METHODS Our large independent cohort of 388 patients with longitudinal measures of BPSD assessed by the Neuropsychiatric Inventory was used to analyse whether any of these variants were associated with the presence of BPSD. RESULTS We revealed several significant relationships before correction for multiple testing. The exon 4 haplotype was associated with hallucinations and anxiety, A-491T with irritability, T-427C with agitation/aggression and appetite disturbances, and T-219C with depression. Haplotype analyses of all variants did not reveal any statistically significant findings. CONCLUSIONS Our data and a review of previous studies showed a diversity of relationships, suggesting that these findings might be due to chance and so collectively do not support a role for the APOE gene in BPSD.
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Affiliation(s)
- A L Pritchard
- Molecular Psychiatry Group, Institute of Biomedical Research, University of Birmingham, Birmingham, UK.
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15
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Hwang JP, Yang CH, Hong CJ, Lirng JF, Yang YM, Tsai SJ. Association of APOE genetic polymorphism with cognitive function and suicide history in geriatric depression. Dement Geriatr Cogn Disord 2007; 22:334-8. [PMID: 16954688 DOI: 10.1159/000095599] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/15/2006] [Indexed: 11/19/2022] Open
Abstract
Apolipoprotein E (APOE) has been associated with a variety of late-life neuropsychiatric disorders, including geriatric depression. This study determined whether APOE genotypes affect vulnerability to geriatric depression. We also tested the effect of the presence of the APOE epsilon4 (APOE4) allele on age of onset, suicide attempt history and cognitive function in geriatric depressed patients. We genotyped APOE in 111 elderly inpatients diagnosed as having major depression and 144 normal controls. The depressed patients were evaluated at baseline using the Hamilton Rating Scale for Depression and the Mini-Mental State Examination (MMSE) after admission. Age of onset of depression and suicide attempt history in the depressed group were evaluated by interview and medical record. We found no association between APOE genotypes and geriatric depression (p = 0.342) or APOE4 status and age of onset of depression (p = 0.281). However, compared with depressed subjects lacking the APOE epsilon4 allele, depressed subjects who were also APOE4 carriers showed significantly lower MMSE scores (p = 0.021) and an increased suicide attempt history (p = 0.012). The APOE genotype may contribute to cognitive performance and suicidality in geriatric depression, rather than being a specific risk factor for the disorder.
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Affiliation(s)
- Jen-Ping Hwang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
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16
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Bowirrat A, Oscar-Berman M, Logroscino G. Association of depression with Alzheimer's disease and vascular dementia in an elderly Arab population of Wadi-Ara, Israel. Int J Geriatr Psychiatry 2006; 21:246-51. [PMID: 16477584 DOI: 10.1002/gps.1455] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Because dementia and depression share common risk factors, we investigated risk factors for depression in Arab subjects with Alzheimer's disease (AD) and vascular dementia (VaD). METHODS In a cross-sectional population-based study, we conducted a door-to-door survey of all adults over age 60 in an Arab community of rural Israel. We conducted interviews, gave questionnaires, and collected DNA blood specimens for determination of ApoE genotype. RESULTS Of the 823 individuals in this naturalistic sample, 168 had dementia of Alzheimer's type (DAT) and 49 had VaD. Vascular risk factors, including the ApoE-epsilon4 allele, were more prevalent among VaD than DAT subjects. Depressive symptoms were present in 57% of DAT patients and 86% of VaD patients. Depressed DAT individuals had a greater history of ischemic cardiovascular or cerebrovascular (CV/CBV) disease than non-depressed DAT subjects, but depressed DAT subjects were less likely to have the ApoE-epsilon4 allele. Within the VaD group, there was no difference in the distribution of cardiovascular risk factors in individuals with and without depressive symptoms, and ApoE-epsilon4 was more prevalent among subjects with depressive symptoms. CONCLUSIONS Depressive symptomatology is prevalent among subjects with dementias in this Arab community. History of CV/CBV is associated with the presence of depressive symptoms in DAT. Further studies are needed to clarify the role of ApoE in depression onset in different ethnic groups with DAT.
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Affiliation(s)
- Abdalla Bowirrat
- The Galilee Society and An-Najah University, Nablus PA, Shefa-Amr, Israel
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17
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Monastero R, Mariani E, Camarda C, Ingegni T, Averna MR, Senin U, Camarda R, Mecocci P. Association between apolipoprotein E epsilon4 allele and apathy in probable Alzheimer's disease. Acta Psychiatr Scand 2006; 113:59-63. [PMID: 16390371 DOI: 10.1111/j.1600-0447.2005.00597.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE There have been inconclusive results to date on the association between the Apolipoprotein E (ApoE) genotype and neuropsychiatric symptoms (NPS) in Alzheimer's disease (AD). We investigated whether ApoE epsilon4 allele is associated with NPS in probable AD. METHOD Data for 197 subjects with probable AD were analysed. The Neuropsychiatric Inventory was used to evaluate the frequency and severity of NPS. Multiple logistic regression models were used to test the association between ApoE genotype and NPS in AD. RESULTS The ApoE epsilon3/3 genotype was present in 52.3%, epsilon3/4 in 44.1%, and epsilon4/4 in 3.6% of patients. ApoE epsilon4 carriers showed a higher frequency of apathy than non-carriers. After multiple adjustments, the ApoE epsilon4 allele was significantly associated with apathy. CONCLUSION Our results suggest a relationship between the ApoE epsilon4 allele and apathy in patients with AD.
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Affiliation(s)
- R Monastero
- Laboratory of Epidemiology and Psychology of Aging and Dementia, Section of Neurology and Psychiatry, DiNOOP, University of Palermo, Palermo, Italy.
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18
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Fan PL, Chen CD, Kao WT, Shu BC, Lung FW. Protective effect of the apo epsilon2 allele in major depressive disorder in Taiwanese. Acta Psychiatr Scand 2006; 113:48-53. [PMID: 16390369 DOI: 10.1111/j.1600-0447.2005.00686.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Major depression is an important comorbidity in Alzheimer's disease, which is definitely associated with the apolipoprotein E (apo E) polymorphism. The aim of this study was to explore the role of the different apo E polymorphisms in major depressive disorder (MDD) in a Taiwanese population. METHOD We examined apo E genotypes in 273 Taiwanese patients with MDD and 429 healthy community controls, and compared their polymorphism distribution. RESULTS The allelic frequency of apo epsilon2 was significantly lower in patients with MDD than in the controls, whereas no significant difference in apo epsilon4 allelic frequency between these two groups was found. CONCLUSION The apo epsilon4 allele was not associated with MDD in this study. However, the finding of a lower frequency of the apo epsilon2 allele in MDD could lead to the conclusion that the apo epsilon2 allele likely provides a protective effect against MDD in the Taiwanese population.
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Affiliation(s)
- P-L Fan
- Military Kaohsiung General Hospital, Kaohsiung, Taiwan
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19
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Tsai SJ. Brain-derived neurotrophic factor: a bridge between major depression and Alzheimer's disease? Med Hypotheses 2003; 61:110-3. [PMID: 12781652 DOI: 10.1016/s0306-9877(03)00141-5] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Cognitive impairment is common in major depression (MD) patients, with these individuals incurring increased risk for development of Alzheimer's disease (AD). Further, depressive symptoms are common in AD patients. This apparent convergence suggests pathogenic factors common to AD and MD. Since decreased brain-derived neurotrophic factor (BDNF), a member of the neurotrophic factor family, is related to both AD and MD, the author suggests that BDNF could be a bridge between AD and MD, explaining both the depressive symptoms in AD, and, cognitive impairment in MD. Evidence supporting this hypothesis suggests that early antidepressants treatment for aged MD patients may decrease the risk of AD, and agents that increase central BDNF may offer an alternative treatment for MD patients with cognitive impairment and/or for AD sufferers with depressive symptoms.
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Müller-Thomsen T, Arlt S, Ganzer S, Mann U, Mass R, Naber D, Beisiegel U. Depression in Alzheimer's disease might be associated with apolipoprotein E epsilon 4 allele frequency in women but not in men. Dement Geriatr Cogn Disord 2002; 14:59-63. [PMID: 12145452 DOI: 10.1159/000064926] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The association between depression and apolipoprotein E (apoE) was investigated in 137 out-patients with Alzheimer's disease. An ICD-10 diagnosis of depression was found in 21.1% of all patients. There was a good correlation between clinicians' diagnoses and blinded rating by the Montgomery-Asberg Depression Rating Scale (r = 0.70). In male patients, apoE 3/3 was detected in 34.1%, 3/4 in 38.6%, 4/4 in 13.6%, 2/4 in 6.8% and 2/3 in 6.8% of cases. In female patients, apoE 3/3 was detected in 35.5%, 3/4 in 45.2%, 4/4 in 12.8%, 2/4 in 3.2% and 2/3 in 3.2% of cases. When analyzing the variance of gene dosage effect, the frequency of the apoE epsilon 4 allele was significantly increased in depressed women but not in men. This effect remained stable in stepwise regression analysis when depression as the dependent variable was tested against the independent variables age, age of onset, duration of disease, cognitive status and years of school education.
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21
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Liu CY, Hong CJ, Liu TY, Lin KN, Wang PN, Chi CW, Chuang YY, Liu HC. Lack of association between the apolipoprotein E genotype and depression in Alzheimer's disease. J Geriatr Psychiatry Neurol 2002; 15:20-3. [PMID: 11936239 DOI: 10.1177/089198870201500105] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The epsilon4 allele of apolipoprotein (apo E) is one of the risk factors for late-onset Alzheimer's disease (AD). We evaluated the association between apo E genotypes and depression in patients with AD. A psychiatrist interviewed all patients and their caregivers for depression using a Chinese version of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised, and for the severity of depression using the Hamilton Depression Rating Scale (HDRS). Twenty-five of the 149 patients with AD were diagnosed with depressive disorders. The numbers of patients in each apo E genotype were 10 in epsilon2/3, 2 in epsilon2/4, 74 in epsilon3/3, 46 in epsilon3/4, and 17 in epsilon4/4. We did not find an association between depression and the presence or absence of the epsilon4 or epsilon2 allele. The HDRS scores were not different in patients with AD with the epsilon4 or epsilon2 allele or in those patients without them. Our study did not find an association between depression and the apo E epsilon4 or epsilon2 allele in AD.
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Affiliation(s)
- Chia-Yih Liu
- Department of Psychiatry, Chang Gung University School of Medicine and Chang Gung Memorial Hospital, Taoyuan, Taiwan
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22
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Scarmeas N, Brandt J, Albert M, Devanand DP, Marder K, Bell K, Ciappa A, Tycko B, Stern Y. Association between the APOE genotype and psychopathologic symptoms in Alzheimer's disease. Neurology 2002; 58:1182-8. [PMID: 11971084 PMCID: PMC3029097 DOI: 10.1212/wnl.58.8.1182] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Psychiatric symptoms occur frequently in the course of AD, are a frequent contributor to institutionalization, predict cognitive decline and death, and often require treatment with psychotropic medications. Previous studies investigating the association between APOE genotype and psychiatric symptomatology in AD have reported contradictory results. OBJECTIVE To determine whether APOE genotype predicts incident psychiatric symptomatology in patients with AD. METHODS Eighty-seven patients with AD at early stages and no psychiatric history were followed semiannually for up to 9.3 years (mean 5.5 years) for development of delusions, illusions, hallucinations, behavioral symptoms, and depression. Cox proportional hazards models were used to examine the relative risk for incident psychiatric symptomatology (outcome) in relation to APOE genotype (predictor). RESULTS The presence of one epsilon4 allele carried a 2.5-fold risk, whereas the presence of two epsilon4 alleles carried a 5.6-fold risk for development of delusions. The associations remained significant even when age, ethnicity, sex, education, duration of disease, and cognitive and functional performance were controlled for. The presence of two epsilon4 alleles was associated with reduced risk for developing hallucinations in the adjusted analysis only. No significant associations were detected between APOE genotype and the incidence of illusions, behavioral symptoms, or depression. CONCLUSION The presence of one or more epsilon4 alleles is a significant predictor for the incidence of delusions in the course of AD.
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Affiliation(s)
- N Scarmeas
- Cognitive Neuroscience Division, Taub Institute for Research in Alzheimer's Disease and the Aging Brain, New York, NY, USA
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Zubenko GS. Do susceptibility loci contribute to the expression of more than one mental disorder? A view from the genetics of Alzheimer's disease. Mol Psychiatry 2000; 5:131-6. [PMID: 10822339 DOI: 10.1038/sj.mp.4000713] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The susceptibility of developing most major psychiatric disorders is determined in part by contributions from risk alleles at multiple genetic loci. The central aim of this article is to highlight evidence from studies of neurodegenerative disorders suggesting that some of these alleles are shared by more than one psychiatric disorder, and to explore mechanisms that may underly these pleiotropic effects. The identification of constellations of susceptibility alleles associated with particular mental disorders will provide opportunities for new insights into the molecular and cellular pathophysiology of these disorders, and will have a major impact on psychiatric research and clinical care. This approach to reducing the variance in etiopathogenesis is also likely to be important for achieving the optimal use of available treatments (maximizing effectiveness and minimizing side effects), and for the discovery of novel medications or other interventions.
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Affiliation(s)
- G S Zubenko
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
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Tunstall N, Owen MJ, Williams J, Rice F, Carty S, Lillystone S, Fraser L, Kehoe P, Neill D, Rudrasingham V, Sham P, Lovestone S. Familial influence on variation in age of onset and behavioural phenotype in Alzheimer's disease. Br J Psychiatry 2000; 176:156-9. [PMID: 10755053 DOI: 10.1192/bjp.176.2.156] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Alzheimer's disease manifests considerable heterogeneity, the cause of which is unknown. AIMS To determine the familial (genotypic) influence on phenomenology (phenotype) in Alzheimer's disease. METHOD Affected sibling pairs with Alzheimer's disease were assessed for a range of cognitive and non-cognitive symptoms. Resemblance for phenotypic characteristics was estimated using intraclass correlations for continuous traits and by pairwise concordance for dichotomous traits. The relationship between age of onset and APOE genotype was examined using linear regression analysis. RESULTS Significant familial effects on age of onset (intraclass correlation 0.41) and mood state (intraclass correlation 0.26), and a relatively high pairwise concordance for agitation (excess concordance 0.1) were found. The APOE locus was found to account for 4% of the variance in age of onset. CONCLUSIONS Substantial familial influence on age of onset, depression and agitation suggests that genotype does influence phenotype in Alzheimer's disease. Establishing the molecular basis for this phenotypic variation may prove relevant to other neuropsychiatric disorders.
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Affiliation(s)
- N Tunstall
- Department of Psychiatry, Institute of Psychiatry, London
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25
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Bellivier F, Laplanche JL, Schürhoff F, Feingold J, Féline A, Jouvent R, Launay JM, Leboyer M. Apolipoprotein E gene polymorphism in early and late onset bipolar patients. Neurosci Lett 1997; 233:45-8. [PMID: 9324236 DOI: 10.1016/s0304-3940(97)00624-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
To explore the involvement of apolipoprotein E gene (APO E) in major depression, we studied the APO E gene polymorphism in a sample of 156 unrelated bipolar patients and 91 healthy volunteers. This population was stratified for age at onset of the affective disorder (onset before 18 years, after 45 years and between 18 and 45 years). Early onset bipolar patients with psychotic symptoms exhibited a significant increase of epsilon4 allele frequency (28.9%) compared to either other bipolar patients (13.1%, chi2 = 6.52, df = 1, P < 0.02) or controls (12.1%, chi2 = 7.01, df = 1, P < 0.01). The association between epsilon4 and early onset bipolar disorder (BPD) with psychotic symptoms suggests that APO E gene is a risk factor for a subgroup of BPD, or influences the phenotypic expression (i.e. psychotic symptoms or age at onset) of manic depressive illness.
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Affiliation(s)
- F Bellivier
- Laboratoire de recherche sur les personnalités et conduites adaptatives, CNRS URA 1957 Pavillon Clérambault, Hôpital Pitié-Salpétrière, Paris, France.
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