OBJECTIVES: To follow up on the increases we reported in normalized metabolic activity in salience network hubs from a 2-month open-label study of memantine in frontotemporal dementia (FTD). METHODS: We repeated fluorodeoxyglucose positron emission tomography (FDG-PET) after 6 months of drug use and subjected the data to Statistical Parametrical Mapping (SPM) analysis to reveal clusters of significant change from baseline. We also sought correlations between changes in behavioral disturbances on the Frontal Behavioral Inventory (FBI) and the PET signal. RESULTS: Recruitment of one progressive nonfluent aphasia and one behavioral variant FTD precluded statistical analysis for any FTD subtype other than semantic dementia (SD). The baseline-to-6-month interval showed increased normalized metabolic activity in the left orbitofrontal cortex (p < 0.002) for five participants with SD. The 2-6-month interval revealed a late increase in normalized metabolic activity in the left insula (p < 0.013), right insula (p < 0.009), and left anterior cingulate (p < 0.005). The right anterior cingulate showed both an initial increase and a delayed further increase (2-6 months, p < 0.016). FBI scores worsened by 43.3%. One participant with SD opted not to continue memantine beyond 2 months yet showed similar FDG-PET increases. CONCLUSIONS: Increases in normalized cortical metabolic activity in salience network hubs were sustained in SD over a 6-month period. Because one participant without medication also showed these changes, further investigation is recommended through a double-blind, placebo-controlled study with FDG-PET as an outcome measure.
RCT Entities:
OBJECTIVES: To follow up on the increases we reported in normalized metabolic activity in salience network hubs from a 2-month open-label study of memantine in frontotemporal dementia (FTD). METHODS: We repeated fluorodeoxyglucose positron emission tomography (FDG-PET) after 6 months of drug use and subjected the data to Statistical Parametrical Mapping (SPM) analysis to reveal clusters of significant change from baseline. We also sought correlations between changes in behavioral disturbances on the Frontal Behavioral Inventory (FBI) and the PET signal. RESULTS: Recruitment of one progressive nonfluent aphasia and one behavioral variant FTD precluded statistical analysis for any FTD subtype other than semantic dementia (SD). The baseline-to-6-month interval showed increased normalized metabolic activity in the left orbitofrontal cortex (p < 0.002) for five participants with SD. The 2-6-month interval revealed a late increase in normalized metabolic activity in the left insula (p < 0.013), right insula (p < 0.009), and left anterior cingulate (p < 0.005). The right anterior cingulate showed both an initial increase and a delayed further increase (2-6 months, p < 0.016). FBI scores worsened by 43.3%. One participant with SD opted not to continue memantine beyond 2 months yet showed similar FDG-PET increases. CONCLUSIONS: Increases in normalized cortical metabolic activity in salience network hubs were sustained in SD over a 6-month period. Because one participant without medication also showed these changes, further investigation is recommended through a double-blind, placebo-controlled study with FDG-PET as an outcome measure.
Authors: D Neary; J S Snowden; L Gustafson; U Passant; D Stuss; S Black; M Freedman; A Kertesz; P H Robert; M Albert; K Boone; B L Miller; J Cummings; D F Benson Journal: Neurology Date: 1998-12 Impact factor: 9.910
Authors: Barry Reisberg; Rachelle Doody; Albrecht Stöffler; Frederick Schmitt; Steven Ferris; Hans Jörg Möbius Journal: N Engl J Med Date: 2003-04-03 Impact factor: 91.245
Authors: S E Starkstein; R Migliorelli; A Tesón; L Sabe; S Vázquez; M Turjanski; R G Robinson; R Leiguarda Journal: J Neurol Neurosurg Psychiatry Date: 1994-07 Impact factor: 10.154
Authors: David L Sultzer; Rebecca J Melrose; Dylan G Harwood; Olivia Campa; Mark A Mandelkern Journal: Am J Geriatr Psychiatry Date: 2010-07 Impact factor: 4.105
Authors: Juan Zhou; Michael D Greicius; Efstathios D Gennatas; Matthew E Growdon; Jung Y Jang; Gil D Rabinovici; Joel H Kramer; Michael Weiner; Bruce L Miller; William W Seeley Journal: Brain Date: 2010-04-21 Impact factor: 13.501
Authors: S G Potkin; R Anand; K Fleming; G Alva; D Keator; D Carreon; J Messina; J C Wu; R Hartman; J H Fallon Journal: Int J Neuropsychopharmacol Date: 2001-09 Impact factor: 5.176
Authors: Tiffany W Chow; Ariel Graff-Guerrero; Nicolaas Plg Verhoeff; Malcolm A Binns; David F Tang-Wai; Morris Freedman; Mario Masellis; Sandra E Black; Alan A Wilson; Sylvain Houle; Bruce G Pollock Journal: Neuropsychiatr Dis Treat Date: 2011-07-13 Impact factor: 2.570