Clinical improvement in a case of frontotemporal dementia under aripiprazole treatment corresponds to partial recovery of disturbed frontal glucose metabolism.
Frontotemporal dementia (FTD) is increasingly recognized as an important type of degenerative dementia but satisfactory pharmacological treatment has not yet been established. We examined the clinical effects of aripiprazole, a new antipsychotic with partial agonistic properties at serotonin 5-HT(1A) and dopamine D(2) receptors, in parallel with cortical glucose metabolism changes. We conducted a follow-up investigation of clinical status and (18)F-fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET) in a 73-year-old male patient with FTD over a 13-month period. Under conventional drug treatment during the first 12 months a marked increase in dementia symptoms was observed. Frontal lobe glucose metabolism clearly decreased during this time period. Under consecutive treatment with aripiprazole a significant and stable improvement of clinical symptoms could be registered, while disturbed frontal glucose metabolism increased significantly. According to this case experience, further investigations should be undertaken to ascertain whether aripiprazole or other atypical antipsychotics with properties to improve impaired dopaminergic transmission in frontal brain regions could qualify for therapy of FTD.
Fellgiebel
Andreas
A
Department of Psychiatry, University Hospital of Mainz, Mainz, Germany. fellgiebel@psychiatrie.klinik.uni-mainz.de
Müller
Matthias J
MJ
Hiemke
Christoph
C
Bartenstein
Peter
P
Schreckenberger
Matthias
M
D000368:Aged; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000068180:Aripiprazole; D001786:Blood Glucose / Q000378:metabolism*; D003704:Dementia / Q000000981:diagnostic imaging / Q000188:drug therapy*; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D005625:Frontal Lobe / Q000000981:diagnostic imaging / Q000187:drug effects*; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D010879:Piperazines / Q000009:adverse effects / Q000627:therapeutic use*; D049268:Positron-Emission Tomography; D011569:Psychiatric Status Rating Scales; D015363:Quinolones / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D001786:Blood Glucose; D010879:Piperazines; D015363:Quinolones; D019788:Fluorodeoxyglucose F18; D000068180:Aripiprazole