title: Abnormal neurotransmitter metabolite levels in Alzheimer patients with a delirium.
abstract: BACKGROUND
  Delirium is a complex neuropsychiatric syndrome with an acute onset and fluctuating course. Several studies have suggested the presence of disturbed cholinergic, dopaminergic and serotonergic pathways in delirium as well as in Alzheimer's disease. Abnormal concentrations of amino acids and of neurotransmitter metabolites have been found in plasma, platelets and cerebrospinal fluid of AD patients, and in plasma and CSF of patients with a delirium. The aim of this study was to investigate amino acid and neurotransmitter metabolite levels in plasma of AD patients with a concurrent delirium.
  
  
  METHODS
  In a case-control study of patients suffering from Alzheimer's disease (AD) with concurrent delirium, we investigated the contribution of delirium to some biochemical parameters in blood. We compared plasma amino acid and neurotransmitter metabolite levels of 17 delirious AD patients with those of 17 age- and gender-matched non-delirious AD patients and 29 age- and gender-matched controls.
  
  
  RESULTS
  Homovanillic acid (HVA) and 5-hydroxyindoleacetic acid (5-HIAA) levels were higher in delirious AD patients than in controls, but only HVA concentrations were higher in delirious AD patients than in non-delirious AD patients.
  
  
  CONCLUSIONS
  Our findings suggest that central dopaminergic and serotonergic turnover are increased in AD patients with delirium and that the high dopaminergic turnover might reflect the consequences of delirium.
authors.affiliation: Section of Geriatric Medicine, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands. t.vandercammen@erasmusmc.nl
authors.forename: Tischa J M
authors.initials: TJ
authors.lastname: van der Cammen
authors.forename: Henning
authors.initials: H
authors.lastname: Tiemeier
authors.forename: Marianne J
authors.initials: MJ
authors.lastname: Engelhart
authors.forename: Durk
authors.initials: D
authors.lastname: Fekkes
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000097:blood* / Q000523:psychology*; D000596:Amino Acids / Q000097:blood; D016022:Case-Control Studies; D003693:Delirium / Q000097:blood / Q000209:etiology*; D005260:Female; D006719:Homovanillic Acid / Q000097:blood; D006760:Hospitalization; D006801:Humans; D006897:Hydroxyindoleacetic Acid / Q000097:blood; D008297:Male; D018377:Neurotransmitter Agents / Q000097:blood*; D011569:Psychiatric Status Rating Scales
chemical_list: D000596:Amino Acids; D018377:Neurotransmitter Agents; D006897:Hydroxyindoleacetic Acid; D006719:Homovanillic Acid