Alzheimer Disease Clinical Trial
Official title:
The Effect of Memantine on Brain Structure and Chemistry in Alzheimer's Disease Patients: A Randomized, Placebo-Controlled, 52-Week Clinical Trial
The aim of the proposed study is to determine if the NMDA receptor antagonist memantine has a neuroprotective effect on magnetic resonance spectroscopic imaging (MRS) measures of brain NAA and magnetic resonance imaging (MRI) volumetric measures of hippocampal volume. In secondary analyses, we will determine if measures of clinical stabilization produced by memantine in the treatment of Alzheimer's disease (AD) parallels stabilization of MRS measures of brain NAA and MRI volumetric measures of hippocampal volume.
Alzheimer's disease (AD) is the most common form of dementia. Currently, there are more than
4 million individuals with dementia in the United States with at least 400,000 deaths
annually. AD is a progressive, neurodegenerative disorder, characterized neuropathologically
by widespread neuronal loss, presence of neurofibrillary tangles, and deposits of beta
amyloid in cerebral blood vessels and neuritic plaques. Since the medial-temporal lobes,
hippocampus, and association cortex are significantly impacted it is not surprising that the
primary symptom of AD is a decline in cognitive functioning that leads to marked impairment
in daily functioning. In particular, memory impairments, visuospatial decline, language
difficulties, and loss of executive function are central cognitive symptoms of this illness.
Behavioral disturbances such as agitation and hallucinations often accompany disease
progression. The illness lasts approximately 7 to 10 years, with patients requiring total
care in the latter stages. Thus, AD places a tremendous emotional and economic burden on
both patients and their caregivers. Beyond a cure, therapeutic approaches which would
alleviate the symptoms or delay progression could be of substantial psychological and
economic benefit. Recent placebo controlled clinical trials have shown memantine to be
efficacious in the treatment of patients with moderate to severe AD.
The aim of the proposed study is to determine if the NMDA receptor antagonist memantine has
a neuroprotective effect on magnetic resonance spectroscopic imaging (MRS) measures of brain
NAA and magnetic resonance imaging (MRI) volumetric measures of hippocampal volume. In
secondary analyses, we will determine if measures of clinical stabilization produced by
memantine in the treatment of Alzheimer's disease (AD) parallels stabilization of MRS
measures of brain NAA and MRI volumetric measures of hippocampal volume.
;
Allocation: Randomized, Endpoint Classification: Pharmacokinetics/Dynamics Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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