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Effects of memantine on clinical ratings, fluorodeoxyglucose positron emission tomography measurements, and cerebrospinal fluid assays in patients with moderate to severe Alzheimer dementia: a 24-week, randomized, clinical trial


Wang, Tao, Huang, Qiu, Reiman, Eric M., Chen, Kewei, Li, Xia, Li, Guanjun, Lin, Zhiguang, Li, Chunbo, Xiao, Shifu


Journal Of Clinical Psychopharmacology, Volume: 33, No.: 5, Pages.: 636-642

Year of Publication



Most experts consider that memantine has a symptomatic treatment, but clinical trials have not yet provided compelling evidence to support a disease-modifying effect. We investigate the effects of memantine on clinical ratings; fluorodeoxyglucose positron emission tomography (FDG-PET) measurements, which can monitor disease-modifying effect; and cerebrospinal fluid (CSF) assays in patients with moderate to severe probable Alzheimer disease (AD) dementia. Twenty-two patients completed a 24-week, double-blind, placebo-controlled, randomized clinical trial of memantine, titrated up to 10 mg twice per day using the Severe Impairment Battery, AD Assessment Scale-Cognitive subscale, Mini-Mental State Examination, FDG-PET measurements of the regional cerebral metabolic rate for glucose (CMRgl), and CSF amyloid β (Aβ) and tau assays. An automated brain mapping algorithm and predefined regions of interest were each used to analyze treatment-related regional CMRgl effects. In comparison with the placebo group, the memantine treatment group had significantly less cognitive decline on the Severe Impairment Battery and significantly less CMRgl declines in regions preferentially affected by AD. There were no significant treatment effects on CSF Aβ₁₋₄₂, CSF Aβ₁₋₄₀, total tau, or phosphor-tau levels or ratios. This relatively small and brief randomized clinical trial suggests an association between memantine’s clinical benefit and its effects on FDG-PET measurements in AD-affected brain regions. Larger and longer studies are needed to confirm these findings, extend them to earlier clinical and preclinical stages of AD, and help determine the extent to which FDG-PET should be qualified for use as a reasonably likely surrogate end point in the evaluation of putative AD-modifying treatments.;

Bibtex Citation

@article{Wang_2013, doi = {10.1097/jcp.0b013e31829a876a}, url = {}, year = 2013, month = {oct}, publisher = {Ovid Technologies (Wolters Kluwer Health)}, volume = {33}, number = {5}, pages = {636--642}, author = {Tao Wang and Qiu Huang and Eric M. Reiman and Kewei Chen and Xia Li and Guanjun Li and Zhiguang Lin and Chunbo Li and Shifu Xiao}, title = {Effects of Memantine on Clinical Ratings, Fluorodeoxyglucose Positron Emission Tomography Measurements, and Cerebrospinal Fluid Assays in Patients With Moderate to Severe Alzheimer Dementia}, journal = {Journal of Clinical Psychopharmacology} }


aged, alzheimer disease, biological markers, brain, cerebrospinal fluid, china, cognition, diagnosis, diagnostic use, double-blind method, drug effects, drug therapy, excitatory amino acid antagonists, female, fluorodeoxyglucose f18, humans, male, memantine, metabolism, middle aged, peptide fragments, phosphorylation, predictive value of tests, psychiatric status rating scales, radionuclide imaging, radiopharmaceuticals, severity of illness index, tau proteins, therapeutic use, time factors, treatment outcome

Countries of Study


Types of Dementia

Alzheimer’s Disease

Types of Study

Randomised Controlled Trial

Type of Outcomes

ADLs/IADLs, Behaviour, Cognition

Type of Interventions

Pharmaceutical Interventions

Pharmaceutical Interventions

Anti-Alzheimer medications, e.g.: donezepil, galantamine, rivastigmine, memantime