PRESYNAPTIC SEROTONERGIC MARKERS IN COMMUNITY-ACQUIRED CASES OF ALZHEIMERS-DISEASE - CORRELATIONS WITH DEPRESSION AND NEUROLEPTIC MEDICATION

Presynaptic serotonergic markers, serotonin uptake sites, and concentr ations of serotonin and 5-hydroxyindoleacetic acid were studied in the frontal and temporal cortex of 20 community-acquired cases of Alzheim er's disease and 16 controls matched for age, sex, postmortem delay, a nd storage, Clinical assessments, including behavioural symptoms, of t he Alzheimer patients were made at 4-month intervals during life. Ther e was a significant reduction in the number of serotonin uptake sites in Alzheimer cases in temporal but not frontal cortex. There was no si gnificant alteration in the concentrations of serotonin or 5-hydroxyin doleacetic acid in either region. Alzheimer patients who had persisten t depressive symptoms during life had significantly fewer serotonin up take sites in both cortical areas compared with Alzheimer patients wit hout these symptoms, In addition. Alzheimer patients who were receivin g chronic neuroleptic medication had significantly lower concentration s of serotonin in frontal cortex and 5-hydroxyindoleacetic acid in tem poral cortex than those patients not receiving such treatment. These d ata suggest previous studies that reported uniform serotonergic dysfun ction may have been subject to unintentional selection of behaviourall y disturbed Alzheimer cases or those receiving chronic neuroleptic med ication. This study also provides a basis for the treatment of behavio urally disturbed Alzheimer patients with serotonomimetics.