title: Efficacy of memantine on neuropsychiatric symptoms associated with the severity of behavioral variant frontotemporal dementia: A six-month, open-label, self-controlled clinical trial.
abstract: Previous studies have focused on the curative effects of memantine in patients with mild-to-moderate frontotemporal lobar degeneration (FTLD); however, its benefits in patients with moderate-to-severe FTLD have not been investigated. The present study explores the behavioral, cognitive and functional effects of memantine on behavioral variant frontotemporal dementia (bvFTD) in patients with mild and moderate-to-severe stage bvFTD. A total of 42 patients with bvFTD completed a 6-month treatment plan of 20 mg memantine daily in an open-label, self-controlled clinical trial. Patients were divided into two groups according to their Mini-Mental State Examination (MMSE) score: Mild (score, 21-26); and moderate-to-severe (score, 4-20). Primary endpoints included Neuropsychiatric Inventory Questionnaire (NPI-Q) and Clinic Dementia Rating (CDR) scores, and secondary endpoints comprised Neuropsychiatric Inventory Caregiver Distress Scale (NPI-D), MMSE, Montreal Cognitive Assessment (MoCA), Activity of Daily Life (ADL) and Hamilton Depression Rating Scale (HAMD) scores. Memantine treatment had no effect on overall NPI-Q scores, with the exception of the agitation subdomain in all patients with bvFTD. However, patients with moderate-to-severe bvFTD exhibited a better performance than patients with mild bvFTD, demonstrated by improved NPI-Q total scores and subscales of agitation, depression, apathy and disinhibition. In the moderate-to-severe group, CDR and HAMD scores remained stable, but MMSE, MoCA and ADL scores were reduced after 6 months of treatment. Memantine was well-tolerated in patients. In conclusion, patients with moderate-to-severe bvFTD responded significantly better to memantine in comparison to patients with mild bvFTD with regard to their neuropsychiatric scores, while memantine did not present any cognitive or functional benefits in patients with mild bvFTD. A randomized, double-blind, placebo-controlled clinical trial with a larger number of patients is required to verify these promising results for patients with moderate-to-severe bvFTD.
authors.affiliation: Department of Neurology, Tianjin Neurological Institute, Tianjin Huanhu Hospital, Tianjin 300060, P.R. China; Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Diseases, Tianjin Huanhu Hospital, Tianjin 300060, P.R. China.
authors.forename: Pan
authors.initials: P
authors.lastname: Li
authors.affiliation: Department of Neurosurgery, Tianjin Medical University, General Hospital, Tianjin 300052, P.R. China; Key Laboratory of Post-trauma Neurorepair and Regeneration in the Central Nervous System, Tianjin Neurological Institute, Ministry of Education, General Hospital, Tianjin 300052, P.R. China; Tianjin Key Laboratory of Injuries, Variations and Regeneration of the Nervous System, General Hospital, Tianjin 300052, P.R. China.
authors.forename: Wei
authors.initials: W
authors.lastname: Quan
authors.affiliation: Department of Neurology, Tianjin Neurological Institute, Tianjin Huanhu Hospital, Tianjin 300060, P.R. China; Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Diseases, Tianjin Huanhu Hospital, Tianjin 300060, P.R. China.
authors.forename: Yu-Ying
authors.initials: YY
authors.lastname: Zhou
authors.affiliation: Department of Neurology, Tianjin Neurological Institute, Tianjin Huanhu Hospital, Tianjin 300060, P.R. China; Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Diseases, Tianjin Huanhu Hospital, Tianjin 300060, P.R. China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Neurology, Tianjin Neurological Institute, Tianjin Huanhu Hospital, Tianjin 300060, P.R. China.
authors.forename: Hui-Hong
authors.initials: HH
authors.lastname: Zhang
authors.affiliation: Department of Neurology, Tianjin Neurological Institute, Tianjin Huanhu Hospital, Tianjin 300060, P.R. China.
authors.forename: Shuai
authors.initials: S
authors.lastname: Liu
keywords: behavioral variant frontotemporal dementia; cognitive function; frontotemporal lobar degeneration; memantine; neuropsychiatric behavior; open-label study