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The aims of this study were to identify subsyndromes of behavioral and psychological symptoms of dementia (BPSD) in Alzheimer disease (AD), and to investigate whether the apolipoprotein E (ApoE) gene confers a risk of distinct BPSD subsyndromes. BPSD of 96 patients with AD were assessed using the Neuropsychiatric Inventory. Factor analysis with principal component analysis and varimax rotation was used to construct the BPSD subsyndromes. ApoE genotypes were determined using the TaqMan technology. The results showed that the 5 subsyndromes can be determined, including: agitation/aggression-delusion, euphoria-disinhibition, depression-apathy, hallucination-nighttime behavior, and appetite. ApoE ε4 carriers had higher factor scores in the agitation/aggression-delusion subsyndrome. We demonstrated that ApoE ε4 confers a higher risk for the subsyndrome of agitation/aggression delusion in AD.

Objectives: Response to an antidepressant is frequently the main goal in treating depression. The purpose of this study was to identify predictor(s) of response to the antidepressant, fluoxetine., Methods: One hundred thirty-one newly hospitalized patients with major depressive disorder received fluoxetine (20 mg/d) for 6 weeks. Symptom severity was assessed using the 17-item Hamilton Depression Rating Scale at weeks 0, 1, 2, 3, 4, and 6. Response was defined as a reduction of ≥50% of the 17-item Hamilton Depression Rating Scale score. We compared the responders and nonresponders in terms of baseline variables. Pain measures included the Short-Form-36 (SF-36) pain severity score and pain interference score. Univariate logistic regression was used to identify variables associated with fluoxetine response., Results: A total of 66 (58.9%) of the 112 completers were classified as responders after a 6-week treatment. The responders and nonresponders did not differ in baseline variables, except melancholic features (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria) and pain measures (SF-36). SF-36 pain severity score had the smallest P value (P=0.015). Its odds ratio (0.70) means that each point increase in the score of pain severity is expected to decrease the chance of response by approximately 30%., Conclusions: These findings from newly hospitalized patients with multiple pain measures support the previous studies, which enrolled mainly outpatients and found that a higher level of pain can have a strong negative impact on the antidepressant response. These data require confirmation and extension to outpatients and other antidepressants.

Background and Purpose: The genetic influence on carotid atherosclerotic plaque is mostly unknown. This study examines the association between carotid plaque and single nucleotide polymorphisms in selected genes implicated in inflammation and endothelial function., Methods: A total of 43 genes (197 single nucleotide polymorphisms) involved in inflammation and endothelial function were interrogated in 287 Dominicans from the Northern Manhattan Study (mean age, 64±7 years; 58% women) who had undergone high-resolution B-mode ultrasound for examination of carotid plaque. Using an additive genetic model, multiple logistic regression analyses were conducted, a within-gene haplotype analysis was performed, and interactions between genes were examined. Results were validated in an independent set of 301 Dominicans., Results: Carotid plaque was present in 143 (47%) participants. Nine genes had at least 1 single nucleotide polymorphism associated (P≤0.01) with carotid plaque phenotypes: TNF, NOS2A, IL6R, TNFSF4, PPARA, IL1A, TLR4, ITGA2, and HABP2. Single nucleotide polymorphisms in TNFSF4, PPARA, TLR4, ITGA2, and HABP2 were also implicated with the same carotid phenotype in the validation analysis. Haplotype analysis revealed an additional gene of interest, VCAM1., Conclusions: We report novel associations between variations in 10 genes involved in inflammation and endothelial function and carotid plaque phenotypes in a Dominican sample, with replication for 5 genes in an independent Dominican sample.