Lopez O L, Kamboh M I, Becker J T, Kaufer D I, DeKosky S T
Alzheimer's Disease Research Center, Department of Neurology, University of Pittsburgh School of Medicine, PA, USA.
Neurology. 1997 Sep;49(3):794-7. doi: 10.1212/wnl.49.3.794.
The objective of our study was to examine the relationship between the presence of the apolipoprotein E (apo E) epsilon 4 allele, psychiatric symptoms, and extrapyramidal signs (EPS) in probable Alzheimer's disease (AD). The apo E epsilon 4 allele modifies the risk and age at onset of AD. However, it still needs to be determined whether it is a marker for specific clinical subgroups. The frequency of clinical signs and symptoms was examined in 194 AD patients with the apo E epsilon 3/3 (N = 79), epsilon 3/4 (N = 96), and epsilon 4/4 (N = 19) genotypes participating in a longitudinal study of dementia. Each patient was assessed with semistructured psychiatric and neurologic examinations. Patients with the epsilon 4/4 genotype had an earlier age at onset of dementia (p = 0.03). However, no individual psychiatric symptom or neurologic sign was associated with the presence of the apo E epsilon 4 allele, including major depression (odds ratio [OR], 1.14; CI, 0.50 to 2.45; p = 0.78), psychosis (e.g., delusions and hallucinations) (OR, 0.66, CI, 0.35 to 1.25; p = 0.20), and EPS (in neuroleptic-free patients) (OR, 0.82, CI, 0.45 to 1.49; p = 0.52), after controlling by age at onset, duration of the symptoms, education, and severity of dementia. The presence of the apo E epsilon 4 allele has limited utility in the characterization of neurologic and psychiatric subgroups in probable AD patients. The apo E epsilon 4/4 genotype appears to be related to age at onset of AD, consistent with previous findings.
我们研究的目的是探讨载脂蛋白E（apo E）ε4等位基因的存在、精神症状与可能患有阿尔茨海默病（AD）患者的锥体外系体征（EPS）之间的关系。apo Eε4等位基因会改变AD发病的风险和年龄。然而，它是否为特定临床亚组的标志物仍有待确定。在一项针对痴呆症的纵向研究中，我们检查了194例载脂蛋白Eε3/3（N = 79）、ε3/4（N = 96）和ε4/4（N = 19）基因型的AD患者的临床体征和症状出现频率。每位患者均接受了半结构化的精神和神经学检查。ε4/4基因型的患者痴呆发病年龄较早（p = 0.03）。然而，在控制发病年龄、症状持续时间、教育程度和痴呆严重程度后，没有任何一种个体精神症状或神经体征与apo Eε4等位基因的存在相关，包括重度抑郁（优势比[OR]，1.14；置信区间[CI]，0.50至2.45；p = 0.78）、精神病（如妄想和幻觉）（OR，0.66，CI，0.35至1.25；p = 0.20）以及EPS（未服用抗精神病药物的患者）（OR，0.82，CI，0.45至1.49；p = 0.52）。apo Eε4等位基因的存在在可能患有AD的患者的神经学和精神亚组特征描述方面的作用有限。apo Eε4/4基因型似乎与AD的发病年龄相关，这与之前的研究结果一致。
