An Open-label Study of Memantine Treatment in 3 Subtypes of Frontotemporal Lobar Degeneration
- 1 July 2009
- journal article
- clinical trial
- Published by Ovid Technologies (Wolters Kluwer Health) in Alzheimer Disease & Associated Disorders
- Vol. 23 (3), 211-217
- https://doi.org/10.1097/wad.0b013e318197852f
Abstract
There are currently no Food and Drug Administration-approved treatments for frontotemporal lobar degeneration (FTLD). The objectives of this study were to explore the tolerability of memantine treatment in FTLD and to monitor for possible effects on behavior, cognition, and function. Forty-three individuals who met clinical criteria for FTLD [21 with frontotemporal dementia (FTD), 13 with semantic dementia (SD), and 9 with progressive nonfluent aphasia (PA)] received 26 weeks of open-label treatment with memantine at a target dose of 20 mg daily. Concurrent treatment with acetylcholinesterase inhibitors was prohibited. Cognitive and functional outcome measures included the Mini Mental State Examination, Alzheimer's Disease Assessment Scale-Cognitive (ADAS-cog), clinical dementia rating-sum of boxes, Neuropsychiatric Inventory (NPI), Frontal Behavior Inventory, Executive Interview (EXIT25), Texas Functional Living Scale (TFLS), Geriatric Depression Scale, and Unified Parkinson's Disease Rating Scale-motor scale. Most subjects were able to tolerate the target dose of memantine. A transient improvement was observed on the total NPI score primarily in the FTD group. Variable declines were observed on the ADAS-cog, EXIT25, Frontal Behavior Inventory, NPI, TFLS, and UPDRS scores. The FTD and SD groups declined on most of the cognitive and behavioral outcome measures, but remained stable on the UPDRS, whereas the progressive nonfluent aphasia group remained relatively stable on the ADAS-cog, NPI, and TFLS, but declined on the UPDRS. Memantine was well-tolerated in these subjects. Future placebo-controlled trials of memantine in FTLD are warranted and may have greater power to detect behavioral and cognitive effects if focused on the FTD and SD clinical syndromes.Keywords
This publication has 28 references indexed in Scilit:
- A 6‐month, open‐label study of memantine in patients with frontotemporal dementiaInternational Journal of Geriatric Psychiatry, 2008
- Clinicopathological correlates in frontotemporal dementiaAnnals of Neurology, 2004
- Memantine Treatment in Patients With Moderate to Severe Alzheimer Disease Already Receiving DonepezilJama-Journal Of The American Medical Association, 2004
- Memantine in Moderate-to-Severe Alzheimer's DiseaseThe New England Journal of Medicine, 2003
- Performance-Based instrument to assess functional capacity in dementia: The Texas Functional Living Scale.2001
- The Clinical Dementia Rating (CDR)Neurology, 1993
- Bedside Assessment of Executive Cognitive Impairment: The Executive InterviewJournal of the American Geriatrics Society, 1992
- A new rating scale for Alzheimer's diseaseAmerican Journal of Psychiatry, 1984
- Development and validation of a geriatric depression screening scale: A preliminary reportJournal of Psychiatric Research, 1983
- “Mini-mental state”: A practical method for grading the cognitive state of patients for the clinicianJournal of Psychiatric Research, 1975