title: Association between subcortical lesions and behavioral and psychological symptoms in patients with Alzheimer's disease.
abstract: OBJECTIVE
  The most devastating features of Alz-heimer's disease (AD) are often the behavioral and psychological symptoms in dementia (BPSD). There is controversy as to whether subcortical lesions contribute to BPSD. The aim of this study was to examine the relationship between BPSD and subcortical lesions (white-matter lesions and lacunes) in AD.
  
  
  METHODS
  CT or MRI from 259 patients with mild-to-moderate AD were assessed with the Age-Related White Matter Changes scale. Linear measures of global and temporal atrophy and Mini-Mental State Examination scores were used to adjust for AD pathology and disease severity in logistic regression models with the BPSD items delusions, hallucinations, agitation, depression, anxiety, apathy and irritability.
  
  
  RESULTS
  Lacunes in the left basal ganglia were associated with delusions (OR 2.57, 95% CI 1.21-5.48) and hallucinations (OR 3.33, 95% CI 1.38-8.01) and lacunes in the right basal ganglia were associated with depression (OR 2.13, 95% CI 1.01-4.51).
  
  
  CONCLUSIONS
  Lacunes in the basal ganglia resulted in a 2- to 3-fold increased risk of delusions, hallucinations and depression, when adjusting for cognition and atrophy. This suggests that basal ganglia lesions can contribute to BPSD in patients with AD, independently of the AD process.
authors.affiliation: Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden. sebastian.palmqvist@med.lu.se
authors.forename: Sebastian
authors.initials: S
authors.lastname: Palmqvist
authors.forename: Agmall
authors.initials: A
authors.lastname: Sarwari
authors.forename: Carina
authors.initials: C
authors.lastname: Wattmo
authors.forename: Lena
authors.initials: L
authors.lastname: Bronge
authors.forename: Yi
authors.initials: Y
authors.lastname: Zhang
authors.forename: Lars Olof
authors.initials: LO
authors.lastname: Wahlund
authors.forename: Katarina
authors.initials: K
authors.lastname: Nägga
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology / Q000523:psychology; D001479:Basal Ganglia / Q000473:pathology; D001480:Basal Ganglia Diseases / Q000150:complications / Q000473:pathology / Q000523:psychology*; D001526:Behavioral Symptoms; D003702:Delusions / Q000150:complications* / Q000473:pathology; D003863:Depression / Q000150:complications* / Q000473:pathology; D005260:Female; D005625:Frontal Lobe / Q000473:pathology; D006212:Hallucinations / Q000150:complications* / Q000473:pathology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010296:Parietal Lobe / Q000473:pathology; D011859:Radiography