The apolipoprotein E epsilon 4 allele increases the risk of drug-induced hallucinations in Parkinson's disease.
To determine whether the apolipoprotein E (APOE) epsilon 4 allele is a risk factor of drug-induced hallucinations in nondemented patients with Parkinson's disease (PD), the proportions of patients with hallucinations in groups with and without the APOE epsilon 4 allele were compared with a chi 2 test. The contribution of the APOE epsilon 4 allele to the occurrence of hallucinations was further evaluated by means of logistic regression models, adjusting for potential prognostic variables. Thirteen (76%) of the 17 patients who had the epsilon 4 allele had visual hallucinations, compared with 20 (23%) of the 88 patients without the epsilon 4 allele (p < 0.0001; odds ratio = 11.05; 95% CI 3.24-37.67). In addition, treatment with dopamine agonists also contributed to an increased risk of hallucinations (p = 0.0011). After adjustment for age, severity of parkinsonism, duration of treatment, dose of levodopa, and treatment with dopamine agonists, the association between the presence of the epsilon 4 allele and the occurrence of visual hallucinations remained significant (p = 0.0003). Nondemented PD patients with the APOE epsilon 4 allele have a high risk of developing drug-induced visual hallucinations. Further studies are needed to evaluate which proportion of these patients will end up developing dementia.
de la Fuente-Fernández
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Department of Neurology, EuroEspes Biomedical Research Center, La Coruña, Spain.
Núñez
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López
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D000368:Aged; D000483:Alleles; D000978:Antiparkinson Agents / Q000009:adverse effects* / Q000627:therapeutic use; D053327:Apolipoprotein E4; D001057:Apolipoproteins E / Q000235:genetics*; D005260:Female; D005838:Genotype; D006212:Hallucinations / Q000139:chemically induced / Q000235:genetics*; D006801:Humans; D016631:Lewy Bodies / Q000235:genetics; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy / Q000235:genetics*
D000978:Antiparkinson Agents; D053327:Apolipoprotein E4; D001057:Apolipoproteins E