Galantamine in frontotemporal dementia and primary progressive aphasia.
OBJECTIVE
The treatment of frontotemporal dementia (FTD) has been mainly symptomatic. Small randomized or open-label case control studies of neurotransmitters have been inconclusive. We tried galantamine in the 2 most common varieties of FTD.


METHODS
Thirty-six behavioral variety FTD and primary progressive aphasia (PPA) patients were treated in an open-label period of 18 weeks and a randomized, placebo-controlled phase for 8 weeks with galantamine. The primary efficacy measures were the Frontal Behavioral Inventory, the Aphasia Quotient of the Western Aphasia Battery, the Clinical Global Impression of Severity and the Clinical Global Impression of Improvement.


RESULTS
No significant differences in behavior or language were found for the total group. A treatment effect (p = 0.009), in a subgroup of subjects with PPA in the global severity score, in favor of galantamine was detected in the placebo-controlled withdrawal phase but was not considered significant after correction for multiple comparisons. The language scores for the treated PPA group also remained stable compared to the placebo group, which showed deterioration.


CONCLUSIONS
Galantamine is not effective in the behavioral variety of FTD, but a trend of efficacy is shown in the aphasic subgroup, which may be clinically significant. Galantamine appeared safe in FTD/PPA.
Kertesz
A
A
Cognitive Neurology and Alzheimer Research Centre, St. Joseph's Hospital, London, Ont., USA. Andrew.Kertesz@sjhc.london.on.ca
Morlog
D
D
Light
M
M
Blair
M
M
Davidson
W
W
Jesso
S
S
Brashear
R
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018888:Aphasia, Primary Progressive / Q000175:diagnosis / Q000188:drug therapy*; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D003704:Dementia / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D005702:Galantamine / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012720:Severity of Illness Index
D002800:Cholinesterase Inhibitors; D005702:Galantamine