The Effect of Memantine on Cognitive Function and Behavioral and Psychological Symptoms in Mild-to-Moderate Alzheimer's Disease Patients

Zhang, Nan; Wei, Changjuan; Du, Hong-jian; Shi, Fu‐Dong; Cheng, Yan

doi:10.1159/000430808

Cited by 28 publications

(15 citation statements)

References 32 publications

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“…Unfortunately, treatment options are limited. Antidepressants may worsen apathy and dementia medications have shown mixed results [14][15][16]. Short-term trials indicate that the stimulant methylphenidate improves apathy in patients with AD [17][18][19], but many individuals cannot tolerate stimulants due to cardiovascular concerns [20].…”

Section: Introductionmentioning

confidence: 99%

Neuromodulation for Apathy in Alzheimer’s Disease: A Double-Blind, Randomized, Sham-Controlled Pilot Study

Padala

Boozer

Lensing

et al. 2020

JAD

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Background: Apathy, a profound loss of motivation, initiation, and goal directed cognition, is a common comorbidity of Alzheimer’s disease (AD). The presence of apathy is associated with rapid progression of AD, long-term impairment, disability, and higher mortality. Pharmacological treatments of apathy are limited. Objective: The primary objective was to evaluate the efficacy of repetitive transcranial magnetic stimulation (rTMS) for apathy in AD. Methods: A randomized, double-blind, parallel-arm, sham-controlled pilot study was conducted in subjects with AD and apathy (N = 20). Subjects were randomized to rTMS or sham treatment (5 days/week) for four weeks. Primary outcome, apathy evaluation scale-clinician version (AES-C), and secondary outcome measures, modified-Mini Mental State Examination (3MS), instrumental activities of daily living (IADL), and clinical global impression (CGI), were assessed at baseline and four weeks. Follow-up visits were conducted at 8 and 12 weeks to test the durability of effects of intervention. Results: Mean age was 77.3 (±7.2) years, 80% were Caucasians and 10% were females. After adjusting for baseline, there was a significantly greater improvement in the AES-C with rTMS compared to sham treatment (–10.1 (–15.9 to –4.3); t (16) = –3.69; p = 0.002) at 4 weeks. There was also significantly greater improvement in 3MS (6.9 (1.7 to 12.0); t (15) = 2.85; p = 0.012), IADL (3.4 (1.0 to 5.9); χ21 = 7.72; p = 0.006), CGI-S (1.4 (0.5 to 2.3), t (16) = 3.29; p = 0.005), and CGI-I (–2.56 (–3.5 to –1.6), t (17) = –5.72; p < 0.001) for rTMS compared to the sham at 4 weeks. The effects of rTMS were durable at 12 weeks. Conclusion: rTMS may be safely used in subjects with AD and may improve apathy, function, and some aspects of cognition.

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Section: Introductionmentioning

confidence: 99%

Neuromodulation for Apathy in Alzheimer’s Disease: A Double-Blind, Randomized, Sham-Controlled Pilot Study

Padala

Boozer

Lensing

et al. 2020

JAD

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“…Pharmacological treatment options for apathy are limited and may not be tolerated by many patients. Medications currently approved for AD have had mixed results in treating apathy; while cholinesterase inhibitors were effective in improving apathy in secondary analyses, memantine failed to do so (Cummings et al, 2015;Zhang et al, 2015). Modest improvements in apathy and cognitive correlates have been noted with dopaminergic agents such as methylphenidate (Padala et al, 2017;Herrmann et al, 2008;Padala et al, 2010;Rosenberg et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Repetitive transcranial magnetic stimulation for apathy in mild cognitive impairment: A double-blind, randomized, sham-controlled, cross-over pilot study

Padala

Lensing

et al. 2018

Psychiatry Research

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Apathy is a common and disabling behavioral concomitant of many neurodegenerative conditions. The presence of apathy with Mild Cognitive Impairment (MCI) is linked with heightened rates of conversion to Alzheimer's disease. Improving apathy may slow the neurodegenerative process. The objective was to establish the efficacy of repetitive transcranial magnetic stimulation (rTMS) in improving apathy in older adults with MCI. An 8-week, double-blind, randomized, sham-controlled cross-over study was conducted in nine subjects (66 ± 9 years) with apathy and MCI. Subjects were randomized to rTMS or sham treatment (5 days/week) for 2 weeks following which they underwent a 4-week treatment-free period. Subjects then crossed-over to receive the other treatment for 2 weeks. The primary (apathy (AES-C)) and secondary (cognition (3MS & MMSE), executive function (TMT-A & TMT-B), and clinical global impression (CGI)) outcomes were assessed at baseline, 2, 6, and 8 weeks. After adjusting for baseline, there was a significantly greater improvement in the AES-C with rTMS compared to sham treatment at 2 weeks. There was significantly greater improvement in 3MS, MMSE, TMT-A, and CGI-I with rTMS compared to the sham treatment. This study establishes that rTMS is efficacious in improving apathy in subjects with MCI.

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“…The current use of memantine is aimed at cognitive and behavioral disorders in patients with mild-moderate-severe AD and mild-moderate vascular dementia (26). It is believed that neuron-protective treatments should be started at very early stages beacuse neuronal damage begins in the pre-clinical phase of the disease.…”

Section: Discussionmentioning

confidence: 99%

The effect of memantine on cognitive performance with amnestic mild cognitive impairment

Algin¹,

Atalay²,

Özkan³

et al. 2017

J Neurol Sci Turk

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Objective: Amnestic mild cognitive impairment (aMCI) refers to cognitive changes that occur during the period of normal cognitive decline and very early dementia. We aimed to assess the efficacy of memantine used for the treatment of patients with aMCI. Methods: All patients were diagnosed as having aMCI according to the Petersen criteria and were assigned to one of three groups. Group 1 comprised patients who received memantine following examination (n=23), group 2 included patients who did not receive memantine treatment following examination (n=22), and group 3 was constituted by healthy age-matched volunteers (n=20). Following the examinations, neuropsychiatric tests from the Turquoise Alzheimer"s Study Group database used in dementia polyclinics were performed. Results: The mean age of patients was 66±7.04 years in group 1, 65.3±6.20 years in group 2, and 57.6±5.40 years in group 3. The most noticeable improvements in group 1 were seen in the Mini-Mental State Exam, Wechsler memory scale subtests, Blessed Dementia Rating Scale, and the Boston Naming Test (p<0.05). Treatment with memantine was associated with an improvement in Geriatric Dementia Scale scores over the 24-week study period. Conclusion: These results suggest that memantine treatment in patients with aMCI acts to enhance cognitive functioning compared with no treatment. These findings suggest the need for a larger randomized placebo-controlled trial.

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The Effect of Memantine on Cognitive Function and Behavioral and Psychological Symptoms in Mild-to-Moderate Alzheimer's Disease Patients

Cited by 28 publications

References 32 publications

Neuromodulation for Apathy in Alzheimer’s Disease: A Double-Blind, Randomized, Sham-Controlled Pilot Study

Neuromodulation for Apathy in Alzheimer’s Disease: A Double-Blind, Randomized, Sham-Controlled Pilot Study

Repetitive transcranial magnetic stimulation for apathy in mild cognitive impairment: A double-blind, randomized, sham-controlled, cross-over pilot study

The effect of memantine on cognitive performance with amnestic mild cognitive impairment

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