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Neuropsychiatric symptoms in dementia: a role for neuroinflammation?
Department of Neurobiology, Care Sciences & Society (NVS), Division of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden.
Department of Neurobiology, Care Sciences & Society (NVS), Division of Neurodegeneration, Karolinska Institutet, Stockholm, Sweden.
Department of Neurobiology, Care Sciences & Society (NVS), Division of Neurodegeneration, Karolinska Institutet, Stockholm, Sweden.
Department of Geriatric Medicine, Karolinska University Hospital Huddinge, Stockholm, Sweden.
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2014 (English)In: Brain Research Bulletin, ISSN 0361-9230, E-ISSN 1873-2747, Vol. 108, p. 88-93, article id S0361-9230(14)00136-1Article in journal (Refereed) Published
Abstract [en]

Dementia is characterized by a progressive cognitive decline and neuropsychiatric symptoms (NPSD) such as agitation, apathy and sleeping problems. There is some evidence of activation of inflammatory pathways in the brain in dementia, but little research has been performed regarding the role of neuroinflammation in NPSD, which might represent a potential novel target for treatment. The aim of this study was to examine the possible association between NPSD and cerebrospinal fluid (CSF) levels of the cytokines IL-6, TNF-α and IL-10, and the cytokine receptor sIL-1RII, in patients with dementia and NPSD. Ninety-four patients (mean age 79±8; 67% female) with a score on the neuropsychiatric inventory (NPI) ≥10 points, were included. Clinical assessment included administration of NPI, the mini-mental state examination (MMSE) and the Cohen-Mansfield agitation inventory (CMAI). The cytokine levels in CSF samples were analysed by enzyme-linked immunosorbent assay. Correlations were statistically examined using Spearman's rank correlation coefficient (r), and simple- and multiple-linear regression. The anti-inflammatory cytokine IL-10 showed reverse correlations with total NPI score (NPI-total=-0.001, t(90)= 8.50, p=0.004) and NPI sub-items agitation (agitation=-0.007, t(90)=7.02, p=0.009) and night-time behaviour (night time behaviour=-0.006, t(90)=6.34, p=0.01). There was a trend towards reverse correlation between IL-10 and depression (depression=-0.004, t(90)=2.96, p=0.09). Also, the soluble cytokine receptor sIL-1RII showed a trend towards correlation with apathy (apathy=0.82, t(82)=3.62, p=0.06). The levels of IL-6 showed no significant correlations with NPSD. Levels of TNF-α were non-detectable. In Alzheimer's disease (AD) subjects (n=33), IL-6 showed reverse correlation with anxiety (r=-0.35, p=0.049). In mixed AD subjects (n=26), IL-10 showed reverse correlations with the total NPI score (r=-0.46, p=0.02) and depression (r=-0.45, p=0.02). The findings indicate a relationship between neuroinflammation and neuropsychiatric symptoms in AD in which anti-inflammatory signalling by IL-10 is beneficial from a mental health perspective.

Place, publisher, year, edition, pages
Elsevier, 2014. Vol. 108, p. 88-93, article id S0361-9230(14)00136-1
Keywords [en]
Alzheimer's disease, BPSD, Behavioural symptoms, Cerebrospinal fluid, Cytokines, NPSD
National Category
Neurology
Identifiers
URN: urn:nbn:se:oru:diva-74151DOI: 10.1016/j.brainresbull.2014.09.003ISI: 000345471900012PubMedID: 25224917Scopus ID: 2-s2.0-84907495042OAI: oai:DiVA.org:oru-74151DiVA, id: diva2:1314547
Funder
Gun och Bertil Stohnes StiftelseThe Dementia Association - The National Association for the Rights of the Demented
Note

Funding Agencies:

Janssen Pharmaceuticals, Stockholm, Sweden  

Petrus and Augusta Hedlunds Foundation 

Loo and Hans Osterman Foundation

Available from: 2019-05-09 Created: 2019-05-09 Last updated: 2019-06-18Bibliographically approved

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Freund-Levi, Yvonne

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