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1、O2-01-08CSF NEUROTRANSMITTER METABOLITES AND BRAIN-SPECIFIC PROTEINS DIFFERENTIATE DEMENTIAWITH LEWY BODIES FROM ALZHEIMERS Marcel Verbeek, Rianne Esselink, Jurgen Claassen, Farid Abdo, Bas Bloem, Marjolein Aerts, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. Background: Dif
2、ferentiating dementia with Lewy bodies (DLB) from Alzheimers Disease (AD) can be diffi cult because of the substantial over- lap in clinical features. Besides, in both AD and DLB CSF amyloid (A) 42 levels are decreased. Since defi cits in serotonergic and dopaminergic pathways are more pronounced in
3、 DLB patients, we investigated whether CSF analysis of neurotransmitter metabolites, additional to the brain-spe- cifi c proteins A42, t-tau and phosphorylated tau (p-tau), may improve the differentiation between DLB and AD. Methods: We retrospectively com- pared CSF concentrations of the neurotrans
4、mitter metabolites MHPG, 5- HIAA,HVAandt-tau,p-tauandA42in45patientswithADand23patients with DLB. Diagnostic evaluation included a detailed medical history, sys- tematic physical and neurological examination, routine laboratory testing and a brain MRI-scan. Cognitive function was assessed using MMSE
5、. Mul- tivariate logistic regression analysis using block entry regression was used to assess the validity of the biomarkers to discriminate AD from DLB. The fi rst block consisted of the clinical parameters age, sex and cognitive function as measured by MMSE. In the second block the currently used
6、brain specifi c proteins were added and in the third block MHPG, HVA and 5-HIAA were entered. Results: The concentrations of 5-HIAA (p 0.01), HVA (p 0.05) and MHPG, t-tau and p-tau (all p 0.0001) were lower in DLB as compared to AD whereas the A42concentrations was higherin DLB thanin AD (p 0.06).RO
7、C-curve analysis of the fi rst model demonstrateda sensitivityof52.4%anda specifi cityof66.7%.Theaddition of t-tau, p-tau and A42in the second block improved the diagnostic accu- racy to a sensitivityof95.2%anda specifi city of88.9%.The subsequentad- dition of MHPG resulted in further improvement of
8、 the diagnostic accuracy withasensitivityof92.9%andaspecifi cityof100.0%forthediscrimination between DLB and AD patients. Conclusions: Low levels of neurotransmit- ter metabolites and the brain specifi c proteins t-tau and p-tau in CSF were associated with the clinical diagnosis of DLB. Importantly,
9、 the combination of MHPG, p-tau, t-tau and A42 analysis discriminated between AD and DLB with high diagnostic accuracy. MONDAY, JULY 18, 2011 ORAL O2-02 CAREGIVING AND CARE PROVISION O2-02-01CAREGIVER AGREEABLENESS, NEUROTICISM, OPENNESS AND EXTRAVERSION ASSOCIATED WITH COGNITIVE DECLINE IN PERSONS
10、WITH ALZHEIMERS DISEASE: THE CACHE COUNTY DEMENTIA PROGRESSION STUDY Maria Norton1, Kyle Hess1, Chris Corcoran1, Kathleen Piercy1, Elizabeth Fauth1, Peter Rabins2, Robert Green3, Constantine Lyketsos4, JoAnn Tschanz1, 1Utah State University, Logan, Utah, United States;2The Johns Hopkins Hospital, Ba
11、ltimore, Maryland, United States; 3Boston University School of Medicine, Boston, Massachusetts, United States; 4Johns Hopkins Medicine, Baltimore, Maryland, United States. Background: Caregiver personality has been linked to mental and phys- ical health outcomes in the caregiver, however, few studie
12、s have exam- ined whether caregiver personality affects the clinical progression of dementia. We previously observed preliminary results in a smaller sample of persons with (incident) Alzheimers disease (PAD) and their care- givers, that high Agreeableness in caregivers was associated with slower co
13、gnitive decline among male but not female care recipients, and spouse but not non-spouse care recipients. We now report fi ndings with a larger sample size, examining fi ve personality domains. Methods: Cognition of 161 PAD (61% females with age M 83.1, SD 6.0 years) was assessed with the Mini-Menta
14、l State Exam (MMSE) at a maximum of 13 visits 6-18 months apart (median follow-up time 6.0 years). Caregivers were 55 spouses, and 106 adult children. Caregiver personality was assessed with the NEO Five Factor Inventory. Linear mixed models of MMSE trajectory wereconducted separatelyforeachpersonal
15、itydomain startingatdementia onset. A curvilinear time effect was signifi cant and captured in models as time. Covariates included PAD gender, education, general health, and neu- ropsychiatric severity; caregiver relationship (spouse vs. adult child), age, and gender. Results: Associations between p
16、ersonality domains and rate of cognitive decline were moderated by relationship and age of dementia on- set (see Figures). Higher Agreeableness was associated with slower cogni- tive decline for older PAD (p .0110). Lower Openness was associated with slower cognitivedecline for younger PAD (p .0100). Lower Neurot- icism was associated with slower cognitive decline for older PAD (p .0176), and those with child caregiver (p .0036). Higher Extraversion was associated with
