Department of Pathophysiology-Electrophysiological Laboratory, Charles University, Faculty of Medicine in Hradec Králové, Czech Republic.
J Clin Neurophysiol. 2010 Oct;27(5):334-40. doi: 10.1097/WNP.0b013e3181f413cb.
The authors tested visual-evoked potentials to pattern-reversal, motion-onset, and visual cognitive event-related potentials in 17 patients with mild-to-moderate Alzheimer's disease treated with Memantine (noncompetitive N-methyl-D-aspartic acid antagonist) to verify whether these objective methods can evaluate its therapeutic effect. The patients were examined before Memantine administration and after 3 and 6 months from the treatment onset. Besides electrophysiology, psychologic Alzheimer Disease Assessment Scale-cognitive part (ADAS-cog) test was also performed. Neither ADAS-cog nor any of the electrophysiological tests were able to prove a significant beneficial effect of Memantine therapy in our group of patients. The results of psychologic and electrophysiological tests did not correlate. An individual improvement of ADAS-cog score (decrease of score by 4 and more points) was present in only 29% of patients, improvement of event-related potentials (shortening of P300 peak latency by at least 20 milliseconds) occurred in 42% of patients. Conversely, in 52% of patients, Memantine therapy led to transitory decline of motion processing (delay of N2 peak latency of the motion-onset visual-evoked potentials by at least 10 milliseconds after the first 3 months of therapy, followed by return to pretherapy values in next 3 months).
作者测试了 17 名轻度至中度阿尔茨海默病患者的视觉诱发电位、运动起始视觉诱发电位和视觉认知事件相关电位，这些患者接受了美金刚（非竞争性 N-甲基-D-天冬氨酸拮抗剂）治疗，以验证这些客观方法是否可以评估其治疗效果。患者在接受美金刚治疗前、治疗开始后 3 个月和 6 个月接受检查。除了电生理学检查外，还进行了心理阿尔茨海默病评估量表认知部分（ADAS-cog）测试。在我们的患者组中，ADAS-cog 或任何电生理测试均未证明美金刚治疗有显著的有益效果。心理和电生理测试的结果没有相关性。仅有 29%的患者 ADAS-cog 评分（评分降低 4 分及以上）有个体改善，42%的患者事件相关电位（P300 峰潜伏期至少缩短 20 毫秒）有改善。相反，在 52%的患者中，美金刚治疗导致运动处理的短暂下降（运动起始视觉诱发电位的 N2 峰潜伏期在治疗的前 3 个月至少延迟 10 毫秒，然后在接下来的 3 个月恢复到治疗前的值）。
