Determining the Association of the 5HTTLPR Polymorphism with Delusions and Hallucinations in Lewy Body Dementias
Determining the Association of the 5HTTLPR Polymorphism with Delusions and Hallucinations in Lewy Body Dementias
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DOI：
10.1016/j.jagp.2012.11.001
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发表时间：
2014-06-01
影响因子：
7.2
通讯作者：
Jones, Emma
中科院分区：
文献类型：
--
作者：
Creese, Byron;Ballard, Clive;Jones, Emma
目的：确定 5HTTLPR 血清素转运蛋白多态性是否与路易体痴呆 (DLB) 和帕金森病痴呆 (PDD) 患者的妄想和幻觉相关。设计：前瞻性队列研究。参与者：本研究共招募了 187 名受试者，分别来自挪威、瑞典和英国的研究中心； 97 名临床或神经病理学诊断为 DLB/PDD 的个体和 90 名认知正常的个体作为对照组。测量：所有患有痴呆症的参与者都接受了神经精神症状的系列评估，以使用哥伦比亚大学阿尔茨海默病精神病理学量表、神经精神量表或当前行为检查来评估是否存在持续性妄想和幻觉。使用简易精神状态检查（MMSE）来测量认知障碍的严重程度。对个体进行 5HTTLPR 多态性基因分型。结果：Logistic 回归表明，L/L 基因型的纯合性和较低的 MMSE 与妄想风险增加相关（比值比：分别为 11.5 和 1.16）。两者都与幻觉没有显着相关。结论：这项研究首次证明 5HTTLPR 多态性与路易体痴呆妄想相关，对于 AD/DLB/PDD 谱系中该症状的潜在机制具有重要意义。需要进一步的研究来进一步调查这种关系并检查治疗机会。
Objectives: To determine whether the 5HTTLPR serotonin transporter polymorphism is associated with delusions and hallucinations in people with dementia with Lewy bodies (DLB) and Parkinson disease dementia (PDD). Design: Prospective cohort study. Participants: A total of 187 individuals, recruited from centres in Norway, Sweden, and the United Kingdom were included in this study; 97 with clinically or neuropathologically diagnosed DLB/PDD and 90 cognitively normal individuals as a comparison group. Measurements: All participants with dementia underwent serial evaluation of neuropsychiatric symptoms to assess the presence of persistent delusions and hallucinations using the Columbia University Scale for Psychopathology in Alzheimer disease, the Neuropsychiatric Inventory, or the Present Behavioural Examination. Severity of cognitive impairment was measured using the Mini Mental State Examination (MMSE). Individuals were genotyped for the 5HTTLPR polymorphism. Results: Logistic regression demonstrated that homozygosity for the L/L genotype and lower MMSE were associated with an increased risk for delusions (odds ratio: 11.5 and 1.16, respectively). Neither was significantly associated with hallucinations. Conclusions: This study is the first to demonstrate the 5HTTLPR polymorphism is associated with delusions in Lewy body dementias, with important implications regarding the mechanisms underlying this symptom across the AD/DLB/PDD spectrum. Further studies are warranted to investigate this relationship further and examine treatment opportunities.