Efficacy of an NMDA Receptor Antagonist for Parkinson's Disease Dementia: A Brain Perfusion SPECT Study

摘要

Memantine's efficacy has been demonstrated in patients with moderate to severe Alzheimer's disease. However, memantine therapy is not typically used in treating Parkinson's disease dementia (PDD), although the deviating glutamatergic pattern evidenced in neuropathological findings suggests that N-methyl D-aspartate receptor antagonists in patients with Lewy-body disorder may be effective. Therefore, we conducted this longitudinal study to confirm the efficacy of memantine for PDD by analyzing comparative changes in regional cerebral blood flow (rCBF) and neuropsychological tests before and after memantine administration in PDD. A total of 18 patients with PDD were enrolled in this study. All patients underwent technetium-99m hexamethylpropyleneamine oxime single photon emission computed tomography and completed neuropsychological tests before and 12 months after memantine administration. This study showed that there was no significant difference in cognitive functioning before and after memantine administration. No significant difference in rCBF was observed in any regions at baseline compared to 12 months after memantine administration. Our results suggest that memantine delays the speed of deterioration in cognitive functioning and behavioral symptoms in PDD because we found no significant changes in rCBF and cognition after memantine treatment.