title: ApoE and SNAP-25 Polymorphisms Predict the Outcome of Multidimensional Stimulation Therapy Rehabilitation in Alzheimer's Disease.
abstract: Alzheimer's disease (AD) is a highly prevalent neurodegenerative disorder. Rate of decline and functional restoration in AD greatly depend on the capacity for neural plasticity within residual neural tissues; this is at least partially influenced by polymorphisms in genes that determine neural plasticity, including Apolipoprotein E4 (ApoE4) and synaptosomal-associated protein of 25 kDa (SNAP-25).
  
  
  
  We investigated whether correlations could be detected between polymorphisms of ApoE4 and SNAP-25 and the outcome of a multidimensional rehabilitative approach, based on cognitive stimulation, behavioral, and functional therapy (multidimensional stimulation therapy [MST]).
  
  
  
  Fifty-eight individuals with mild-to-moderate AD underwent MST for 10 weeks. Neuro-psychological functional and behavioral evaluations were performed blindly by a neuropsychologist at baseline and after 10 weeks of therapy using Mini-Mental State Examination (MMSE), Functional Living Skill Assessment (FLSA), and Neuropsychiatric Inventory (NPI) scales. Molecular genotyping of ApoE4 and SNAP-25 rs363050, rs363039, rs363043 was performed. Results were correlated with ΔMMSE, ΔNPI and ΔFLSA scores by multinomial logistic regression analysis.
  
  
  
  Polymorphisms in both genes correlated with the outcome of MST for MMSE and NPI scores. Thus, higher overall MMSE scores after rehabilitation were detected in ApoE4 negative compared to ApoE4 positive patients, whereas the SNAP-25 rs363050(G) and rs363039(A) alleles correlated with significant improvements in behavioural parameters.
  
  
  
  Polymorphisms in genes known to modulate neural plasticity might predict the outcome of a multistructured rehabilitation protocol in patients with AD. These data, although needing confirmation on larger case studies, could help optimizing the clinical management of individuals with AD, for example defining a more intensive treatment in those subjects with a lower likelihood of success.
authors.affiliation: Don C. Gnocchi Foundation IRCCS, Milan, Italy fguerini@dongnocchi.
authors.forename: Franca Rosa
authors.initials: FR
authors.lastname: Guerini
authors.affiliation: Don C. Gnocchi Foundation IRCCS, Milan, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Farina
authors.affiliation: Don C. Gnocchi Foundation IRCCS, Milan, Italy.
authors.forename: Andrea Saul
authors.initials: AS
authors.lastname: Costa
authors.affiliation: Don C. Gnocchi Foundation IRCCS, Milan, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Baglio
authors.affiliation: Don C. Gnocchi Foundation IRCCS, Milan, Italy.
authors.forename: Francesca Lea
authors.initials: FL
authors.lastname: Saibene
authors.affiliation: Don C. Gnocchi Foundation IRCCS, Milan, Italy.
authors.forename: Nicolò
authors.initials: N
authors.lastname: Margaritella
authors.affiliation: Don C. Gnocchi Foundation IRCCS, Milan, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Calabrese
authors.affiliation: Don C. Gnocchi Foundation IRCCS, Milan, Italy.
authors.forename: Milena
authors.initials: M
authors.lastname: Zanzottera
authors.affiliation: Don C. Gnocchi Foundation IRCCS, Milan, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Bolognesi
authors.affiliation: Don C. Gnocchi Foundation IRCCS, Milan, Italy University of Milan, Milan, Italy.
authors.forename: Raffaello
authors.initials: R
authors.lastname: Nemni
authors.affiliation: Don C. Gnocchi Foundation IRCCS, Milan, Italy University of Milan, Milan, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Clerici
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000235:genetics* / Q000534:rehabilitation*; D001057:Apolipoproteins E / Q000235:genetics*; D015928:Cognitive Behavioral Therapy / Q000379:methods; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008609:Mental Status Schedule; D009483:Neuropsychological Tests; D009788:Occupational Therapy / Q000379:methods; D020641:Polymorphism, Single Nucleotide / Q000235:genetics*; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D018709:Statistics, Nonparametric; D050825:Synaptosomal-Associated Protein 25 / Q000235:genetics*; D016896:Treatment Outcome
chemical_list: D001057:Apolipoproteins E; C494208:SNAP25 protein, human; D050825:Synaptosomal-Associated Protein 25
keywords: Alzheimer’s disease; ApoE; SNAP-25; multidimensional stimulation therapy; rehabilitation