van der Flier Wiesje M, Staekenborg Salka, Pijnenburg Yolande A L, Gillissen Freek, Romkes Rolinka, Kok Astrid, Bouwman Femke H, Scheltens Philip
Department of Neurology and Alzheimer Center, Vrije Universiteit Medical Center, Amsterdam, The Netherlands.
Dement Geriatr Cogn Disord. 2007;23(1):42-6. doi: 10.1159/000096682. Epub 2006 Oct 31.
We investigated differences in the prevalence and severity of 10 neuropsychiatric and behavioral symptoms according to apolipoprotein E (APOE) genotype and dementia severity in Alzheimer disease (AD).
Neuropsychiatric and behavioral symptoms of 110 AD patients were assessed using the Neuropsychatric Inventory. Dementia severity was assessed using the Mini Mental State Examination (MMSE).
There were 27 APOE-epsilon4-negative patients, 65 heterozygous patients and 18 homozygous patients. There was a significant association between the number of APOE epsilon4 alleles and prevalence and severity of neuropsychiatric and behavioral symptoms that was mainly attributable to delusions and agitation/aggression, which were more common and severer among homozygous APOE epsilon4 carriers. In addition, the presence of hallucinations, anxiety, apathy and aberrant motor behavior increased with deteriorating MMSE score, independently of APOE epsilon4 status.
The present study showed that the APOE epsilon4 genotype modifies neuropsychiatric and behavioral phenotype in AD. In particular, it was shown that delusions and agitation/aggression were more common and severer among homozygous APOE epsilon4 carriers than among heterozygous or APOE-epsilon4-negative patients.
我们根据载脂蛋白E（APOE）基因型和阿尔茨海默病（AD）的痴呆严重程度，研究了10种神经精神和行为症状的患病率及严重程度差异。
使用神经精神科问卷对110例AD患者的神经精神和行为症状进行评估。使用简易精神状态检查表（MMSE）评估痴呆严重程度。
有27例APOE-ε4阴性患者、65例杂合子患者和18例纯合子患者。APOE ε4等位基因数量与神经精神和行为症状的患病率及严重程度之间存在显著关联，这主要归因于妄想以及激越/攻击行为，这些症状在APOE ε4纯合子携带者中更为常见且严重。此外，幻觉、焦虑、淡漠和异常运动行为的出现随MMSE评分恶化而增加，与APOE ε4状态无关。
本研究表明，APOE ε4基因型改变了AD的神经精神和行为表型。特别是，研究表明妄想以及激越/攻击行为在APOE ε4纯合子携带者中比在杂合子或APOE-ε4阴性患者中更常见且严重。
