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Chow T.W.,Baycrest | Chow T.W.,Center for Addiction and Mental Health Center | Graff-Guerrero A.,Center for Addiction and Mental Health Center | Verhoeff N.P.L.G.,Baycrest | And 16 more authors.
Neuropsychiatric Disease and Treatment | Year: 2011

Background: Memantine has shown effects on cortical metabolism in Alzheimer's disease (AD), and the mechanism of action may not be specific to AD alone. We hypothesized that participants with frontotemporal dementia taking memantine would show an increased cortical metabolic activity in frontal regions, temporal regions, or in salience network hubs. Methods: Sixteen participants with behavioral or language variant frontotemporal dementia syndromes (FTD) were recruited from tertiary FTD clinics and treated with memantine hydrochloride 10 mg twice daily in this fixed-dose, open-label pilot study. The primary endpoint was enhancement of cortical metabolic activity after 7-8 weeks of treatment. Secondary endpoints were measures of mood and behavior disturbance, frontal executive function, and motor disturbance. Results: Voxel-wise parametric image analysis of positron emission tomography (PET) data from seven behavioral variant FTD patients, eight semantic dementia patients, and one progressive nonfluent aphasia patient, of mean age 64.3 years, mean duration of illness 4.25 years, and baseline mean sum of boxes Clinical Dementia Rating score 6.59, revealed an increase in [18F]-fluorodeoxyglucose (FDG) normalized metabolic activity in bilateral insulae and the left orbitofrontal cortex (P < 0.01). The increase on FDG-PET did not correlate with changes on behavioral inventories. Post hoc analysis indicated that semantic dementia participants drove this finding. Conclusion: This open-label clinical PET study suggests that memantine induces an increase in metabolism in the salience network in FTD. A placebo-controlled follow-up study is warranted. © 2011 Chow et al.


Links K.A.,Rotman Research Institute | Black S.E.,Rotman Research Institute | Black S.E.,University of Toronto | Black S.E.,Sunnybrook Health science Center | And 10 more authors.
Neurocase | Year: 2013

Objective: To study the effect of memantine on apathy, a common symptom of behavioral variant frontotemporal dementia (bvFTD). Design: The patient underwent an off-label trial of memantine with behavioral inventories and [18F]fluorodeoxyglucose positron emission tomography (FDG-PET) scans performed at baseline, 7 weeks and 6 months. Subject: The patient was a 66-year-old male whose main manifestation of bvFTD was affective, behavioral and cognitive apathy. Intervention: The patient began memantine at an oral dose of 5 mg per morning and titrated up by 5 mg per week to the maintenance dose of 10 mg PO bid. Results: Informants reported reduction of the apathy. The insula and cerebellum, both involved in the salience network, showed improved metabolism. Conclusion: Further study to correlate the effects of memantine on apathy and the salience network in bvFTD are warranted. © 2013 Copyright Taylor and Francis Group, LLC.

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