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Background Depression symptoms may be associated with the development of Alzheimer disease (AD). Objectives To evaluate the association between depression symptoms and risk of AD, and to explore the temporal aspects of this association. Setting Academic institutions with specialized memory clinics. Design Cross-sectional, family-based, case-control study with standardized self- and proxy questionnaires to collect information on depression symptoms and other risk factors. Participants A total of 1953 subjects with AD and 2093 of their unaffected relatives enrolled in the Multi-institutional Research in Alzheimer's Genetic Epidemiology Study. Main Outcome Measures Odds ratios (ORs) of AD were estimated with and without depression symptoms, adjusted for age, sex, education, history of head trauma, and apolipoprotein E status. Results There was a significant association between depression symptoms and AD (adjusted OR, 2.13; 95% confidence interval [CI], 1.71-2.67). In families where depression symptoms first occurred within 1 year before the onset of AD, the association was higher (OR, 4.57; 95% CI, 2.87-7.31), while in the families where the depression symptoms first occurred more than 1 year before the onset of AD, the association was lower (OR, 1.38; 95% CI, 1.03-1.85). In families where depression symptoms first occurred more than 25 years before the onset of AD, there was still a modest association (OR, 1.71; 95% CI, 1.03-2.82). Conclusions Depression symptoms before the onset of AD are associated with the development of AD, even in families where first depression symptoms occurred more than 25 years before the onset of AD. These data suggest that depression symptoms are a risk factor for later development of AD.

• This study investigated the relationship between severity of auditory comprehension in Wernicke's aphasia and amount of temporal lobe damage within Wernicke's area (posterior two thirds of superior temporal gyrus region) as well as the total temporoparietal lesion size. There was a highly significant correlation between comprehension and the amount of temporal lobe lesion in Wernicke's area. There was no significant correlation between comprehension and the total temporoparietal lesion size. Patients with damage in only half or less than half of Wernicke's area had good comprehension at six months after the onset of stroke. Patients with damage in more than half of Wernicke's area had poor comprehension even one year after the onset of stroke. Additional anterior-inferior temporal lobe lesion extension into the middle temporal gyrus area was associated with particularly poor recovery.

To the Editor.— Central pain disorders have been described previously in detail. Recently, central dazzle or central photophobia has been reviewed by Cummings and Gittinger (Archives1981;38:372-374) and a parallel has been drawn to central pain syndromes. These authors described a patient with a posterior cerebral artery infarct in whom disturbing central dazzle subsequently developed, necessitating the use of sunglasses and light occlusion. This problem may represent an example of a more general family of disorders related to disorders of sensory efferent pathways. The following is a case of a central "razzle," a disorder similar to central dazzle, that refers to a bothersome sensation elicited by auditory stimuli. Report of a Case.— We recently examined a 58-year-old man with the syndrome of pure word deafness associated with a small left superior temporal infarct and a larger right parietotemporal infarct (S.H.A., T. Allard, MA, M. Naeser, PhD, et al, 1980). Clinically

• Idiopathic peripheral facial palsies in the pediatric population have been noted to carry a favorable prognosis. We describe three members of a family, including two children with recurrent facial palsy, and review the relevant literature. As recurrent peripheral facial palsies carry a relatively poor prognosis, the physician should be alerted to this possibility in any child who has an idiopathic peripheral facial palsy and a positive family history.