title: Behavioral correlates of cerebrospinal fluid amino acid and biogenic amine neurotransmitter alterations in dementia.
abstract: BACKGROUND
  Behavioral and psychological signs and symptoms of dementia (BPSD) are a heterogeneous group of behavioral and psychiatric disturbances occurring in dementia patients of any etiology. Research suggests that altered activities of dopaminergic, serotonergic, (nor)adrenergic, as well as amino acid neurotransmitter systems play a role in the etiopathogenesis of BPSD. In this study we attempted to identify cerebrospinal fluid (CSF) neurochemical correlates of BPSD to provide further insight into its underlying neurochemical pathophysiological mechanisms.
  
  
  METHODS
  Patients with probable Alzheimer's disease (AD; n = 202), probable AD with cerebrovascular disease (n = 37), probable frontotemporal dementia (FTD; n = 32), and probable dementia with Lewy bodies (DLB; n = 26) underwent behavioral assessment and lumbar puncture. CSF levels of six amino acids and several biogenic amines and metabolites were analyzed using ultraperformance liquid chromatography with fluorescence detection and reversed-phase high-performance liquid chromatography with fluorescence detection.
  
  
  RESULTS
  In the AD patients, CSF homovanillic acid/5-hydroxyindoleacetic acid (HVA/5HIAA) ratios correlated positively with anxieties/phobias, whereas CSF levels of taurine correlated negatively with depression and behavioral disturbances in general. In FTD patients, CSF levels of glutamate correlated negatively with verbally agitated behavior. In DLB patients, CSF levels of HVA correlated negatively with hallucinations.
  
  
  CONCLUSIONS
  Several neurotransmitter systems can be linked to one specific behavioral syndrome depending on the dementia subtype. In addition to biogenic amines and metabolites, amino acids seem to play a major role in the neurochemical etiology of BPSD as well.
authors.affiliation: Laboratory of Neurochemistry and Behavior, Reference Center for Biological Markers of Dementia, University of Antwerp, Antwerp, Belgium.
authors.forename: Yannick
authors.initials: Y
authors.lastname: Vermeiren
authors.forename: Nathalie
authors.initials: N
authors.lastname: Le Bastard
authors.forename: An
authors.initials: A
authors.lastname: Van Hemelrijck
authors.forename: Wilhelmus H
authors.initials: WH
authors.lastname: Drinkenburg
authors.forename: Sebastiaan
authors.initials: S
authors.lastname: Engelborghs
authors.forename: Peter P
authors.initials: PP
authors.lastname: De Deyn
mesh_terms: D000368:Aged; D000596:Amino Acids / Q000134:cerebrospinal fluid*; D001679:Biogenic Amines / Q000134:cerebrospinal fluid*; D002851:Chromatography, High Pressure Liquid; D003704:Dementia / Q000134:cerebrospinal fluid* / Q000150:complications / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000134:cerebrospinal fluid / Q000209:etiology*; D018377:Neurotransmitter Agents / Q000134:cerebrospinal fluid*
chemical_list: D000596:Amino Acids; D001679:Biogenic Amines; D018377:Neurotransmitter Agents