Apolipoprotein ɛ4 advances appearance of psychosis in patients with Parkinson's disease
Identifieur interne : 001357 ( Main/Exploration ); précédent : 001356; suivant : 001358Apolipoprotein ɛ4 advances appearance of psychosis in patients with Parkinson's disease
Auteurs : B. Feldman [Israël] ; J. Chapman [Israël] ; A. D. Korczyn [Israël]Source :
- Acta Neurologica Scandinavica [ 0001-6314 ] ; 2006-01.
English descriptors
Abstract
Background – Psychosis is one of the most serious complications of advanced parkinsonism, but many patients are spared. The genetic factors predisposing to psychosis are unclear. Objectives – To assess the association between apolipoprotein E (APOE) polymorphism and the development of psychosis in patients with Parkinson's disease (PD). Methods – Eighty‐seven patients with advanced PD were assessed. Psychosis was diagnosed in 50 patients who manifested paranoid delusions, hallucinations without insight, or disorders of perception. Time of onset of psychosis was retrieved from the medical records and caregivers’ recall. APOE genotype was determined by restriction enzyme digests of amplified alleles. Cox models of logistic regression and Kaplan–Meier survival curves were used to assess factors determining early development of psychosis. Results – APOE ɛ3/ɛ4 allele was carried by 20 patients (14 with psychosis), ɛ2/ɛ3 by 11 patients (10 with psychosis), ɛ3/ɛ3 by 55 patients (25 with psychosis) and ɛ2/ɛ4 by one patient who had psychosis. The mean age of onset of PD symptoms was 60.0 ± 12.5 years. The mean duration of motor symptoms at the onset of psychosis was 7.3 ± 4.3 years for the 15 patients harboring an APOE ɛ4 allele and 10.1 ± 6.2 years among those who did not carry APOE ɛ4 (n = 35). The APOE ɛ4 allele was significantly associated with earlier onset of psychosis (P < 0.05) when the age of onset of motor symptoms and presence of dementia were included in the Cox regression model. Carrying the APOE ɛ4 allele was a significant risk factor for earlier appearance of psychosis with a hazard ratio of 3.24 (95% CI 1.62–6.46) while dementia by itself did not increase the risk. Conclusion – Parkinson's disease patients who carry the APOE ɛ4 allele develop psychosis earlier.
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DOI: 10.1111/j.1600-0404.2005.00535.x
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Korczyn</name></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:64B60B7D001CA197FD7EB87BD1D2E83CD53208EA</idno><date when="2006" year="2006">2006</date><idno type="doi">10.1111/j.1600-0404.2005.00535.x</idno><idno type="url">https://api.istex.fr/document/64B60B7D001CA197FD7EB87BD1D2E83CD53208EA/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">000F11</idno><idno type="wicri:Area/Main/Curation">000D39</idno><idno type="wicri:Area/Main/Exploration">001357</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Apolipoprotein ɛ4 advances appearance of psychosis in patients with Parkinson's disease</title><author><name sortKey="Feldman, B" sort="Feldman, B" uniqKey="Feldman B" first="B." last="Feldman">B. Feldman</name><affiliation wicri:level="1"><country xml:lang="fr">Israël</country><wicri:regionArea>Be'er Yakov Mental Health Center, Be'er Yakov</wicri:regionArea><wicri:noRegion>Be'er Yakov</wicri:noRegion></affiliation></author><author><name sortKey="Chapman, J" sort="Chapman, J" uniqKey="Chapman J" first="J." last="Chapman">J. Chapman</name><affiliation wicri:level="1"><country xml:lang="fr">Israël</country><wicri:regionArea>Department of Neurology, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel‐Aviv</wicri:regionArea><wicri:noRegion>Tel‐Aviv</wicri:noRegion></affiliation></author><author><name sortKey="Korczyn, A D" sort="Korczyn, A D" uniqKey="Korczyn A" first="A. D." last="Korczyn">A. D. Korczyn</name><affiliation wicri:level="1"><country xml:lang="fr">Israël</country><wicri:regionArea>Be'er Yakov Mental Health Center, Be'er Yakov</wicri:regionArea><wicri:noRegion>Be'er Yakov</wicri:noRegion></affiliation><affiliation wicri:level="1"><country xml:lang="fr">Israël</country><wicri:regionArea>Department of Neurology, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel‐Aviv</wicri:regionArea><wicri:noRegion>Tel‐Aviv</wicri:noRegion></affiliation><affiliation wicri:level="1"><country xml:lang="fr">Israël</country><wicri:regionArea>Sieratzky Chair of Neurology, Tel Aviv University, Ramat Aviv</wicri:regionArea><wicri:noRegion>Ramat Aviv</wicri:noRegion></affiliation></author></analytic><monogr></monogr><series><title level="j">Acta Neurologica Scandinavica</title><idno type="ISSN">0001-6314</idno><idno type="eISSN">1600-0404</idno><imprint><publisher>Munksgaard International Publishers</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2006-01">2006-01</date><biblScope unit="volume">113</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="14">14</biblScope><biblScope unit="page" to="17">17</biblScope></imprint><idno type="ISSN">0001-6314</idno></series><idno type="istex">64B60B7D001CA197FD7EB87BD1D2E83CD53208EA</idno><idno type="DOI">10.1111/j.1600-0404.2005.00535.x</idno><idno type="ArticleID">ANE535</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0001-6314</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Parkinson's disease</term><term>apolipoprotein E</term><term>dementia</term><term>neurodegeneration</term><term>psychosis</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background – Psychosis is one of the most serious complications of advanced parkinsonism, but many patients are spared. The genetic factors predisposing to psychosis are unclear. Objectives – To assess the association between apolipoprotein E (APOE) polymorphism and the development of psychosis in patients with Parkinson's disease (PD). Methods – Eighty‐seven patients with advanced PD were assessed. Psychosis was diagnosed in 50 patients who manifested paranoid delusions, hallucinations without insight, or disorders of perception. Time of onset of psychosis was retrieved from the medical records and caregivers’ recall. APOE genotype was determined by restriction enzyme digests of amplified alleles. Cox models of logistic regression and Kaplan–Meier survival curves were used to assess factors determining early development of psychosis. Results – APOE ɛ3/ɛ4 allele was carried by 20 patients (14 with psychosis), ɛ2/ɛ3 by 11 patients (10 with psychosis), ɛ3/ɛ3 by 55 patients (25 with psychosis) and ɛ2/ɛ4 by one patient who had psychosis. The mean age of onset of PD symptoms was 60.0 ± 12.5 years. The mean duration of motor symptoms at the onset of psychosis was 7.3 ± 4.3 years for the 15 patients harboring an APOE ɛ4 allele and 10.1 ± 6.2 years among those who did not carry APOE ɛ4 (n = 35). The APOE ɛ4 allele was significantly associated with earlier onset of psychosis (P < 0.05) when the age of onset of motor symptoms and presence of dementia were included in the Cox regression model. Carrying the APOE ɛ4 allele was a significant risk factor for earlier appearance of psychosis with a hazard ratio of 3.24 (95% CI 1.62–6.46) while dementia by itself did not increase the risk. Conclusion – Parkinson's disease patients who carry the APOE ɛ4 allele develop psychosis earlier.</div></front></TEI><affiliations><list><country><li>Israël</li></country></list><tree><country name="Israël"><noRegion><name sortKey="Feldman, B" sort="Feldman, B" uniqKey="Feldman B" first="B." last="Feldman">B. 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