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MR spectroscopy for assessment of memantine treatment in mild to moderate Alzheimer dementia

Authors

Ashford, J. W., Adamson, M., Beale, T., La, D., Hernandez, B., Noda, A., Rosen, A., O'Hara, R., Fairchild, J. K., Spielman, D., Yesavage, J. A.

Journal

Journal Of Alzheimer's Disease: JAD, Volume: 26 Suppl 3, Pages.: 331-336

Year of Publication

2011

Abstract

Objectives: Magnetic Resonance Spectroscopy (MRS) may provide a precise and reliable assessment of the extent and severity of neural tissue loss caused by various diseases. In particular, the N-Acetyl Aspartate (NAA) and Creatine (Cr) ratio has been found to be an indicator of the degree of neuronal loss in Alzheimer’s disease (AD). Memantine is thought to benefit the AD brain by stabilizing the NMDA receptors on neurons in turn reducing excitotoxicity. Despite its effectiveness in treating moderate to severe AD, memantine has not had similar success in the treatment of mildly demented AD patients. The objective of this study was to test whether memantine would slow or prevent the loss of neurons in mild to moderate AD patients.; Methods: A double-blind placebo-controlled study was designed to measure the effect of a year-long course of memantine in patients with a probable AD diagnosis with mild to moderate dementia. The primary outcome measure was stipulated to be change in MRS NAA/Cr ratio in inferior parietal cortex in memantine relative to the placebo treatment condition. The secondary outcome measures were changes in cognitive and function scale scores.; Results: This pilot study failed to demonstrate a benefit of memantine on the primary outcome measure, the inferior parietal NAA/Cr ratio, or the secondary outcome measures.; Conclusions: More studies are needed to determine the effect of memantine on regions of the brain significantly affected by AD pathology.;

Keywords

aged, aged, 80 and over, alzheimer disease, analogs derivatives, aspartic acid, brain mapping, creatine, diagnosis, double-blind method, drug therapy, excitatory amino acid antagonists, female, humans, longitudinal studies, loss, magnetic resonance spectroscopy, male, memantine, metabolism, neuronal, neuropsychological tests, pilot projects, therapeutic use

Countries of Study

USA

Types of Dementia

Alzheimer’s Disease

Types of Study

Randomised Controlled Trial

Type of Outcomes

ADLs/IADLs, Cognition, Other

Type of Interventions

Pharmaceutical Interventions

Pharmaceutical Interventions

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