Matsuzono Kosuke, Yamashita Toru, Ohta Yasuyuki, Hishikawa Nozomi, Koike Makoto, Sato Kota, Kono Syoichiro, Deguchi Kentaro, Nakano Yumiko, Abe Koji
J Alzheimers Dis. 2015;47(2):487-93. doi: 10.3233/JAD-150094.
The clinical benefits of memantine, depending on the baseline cognitive and affective conditions in real world dementia clinics, have not been completely examined. We performed the "Okayama Memantine Study II (OMS II)" to retrospectively evaluate the clinical effects of memantine monotherapy (n = 38) in Alzheimer's disease (AD) patients using seven batteries to assess dementia at the baseline, at 3, 6, and 12 months. Additionally, we divided 163 AD patients treated with memantine into two subgroups depending on the baseline cognitive score of the Mini-Mental State Examination (MMSE): the MMSE <15 group (n = 36) and the baseline MMSE ≥15 group (n = 127). We also analyzed 71 AD patients based on the baseline behavioral and psychological symptoms of dementia (BPSD) severity using Abe's BPSD score (ABS). Memantine monotherapy maintained cognitive functions until 6 months of treatment, but showed a decrease at 12 months ( *p < 0.05 versus baseline). However, memantine monotherapy greatly improved BPSD symptoms until 12 months ( *p < 0.05, **p < 0.01) and maintained other affective functions as well as the activity of daily living. Memantine treatment showed similar effects, regardless of the baseline cognitive functions, but showed better effects on ABS for higher baseline cognitive functions. Memantine treatment greatly improved ABS depending on baseline BPSD severity. Our present OMS II showed that memantine monotherapy improved BPSD until 12 months. The higher baseline cognitive subgroup (MMSE ≥15) and the worse baseline BPSD subgroup were expected to show better effects with memantine.
美金刚的临床益处，取决于现实世界中痴呆症诊所的基线认知和情感状况，尚未得到全面研究。我们开展了“冈山美金刚研究II（OMS II）”，以回顾性评估美金刚单药治疗（n = 38）对阿尔茨海默病（AD）患者的临床效果，使用七个量表在基线、3个月、6个月和12个月时评估痴呆情况。此外，我们根据简易精神状态检查表（MMSE）的基线认知得分，将163例接受美金刚治疗的AD患者分为两个亚组：MMSE <15组（n = 36）和基线MMSE≥15组（n = 127）。我们还根据阿部痴呆行为和心理症状评分（ABS），对71例AD患者的基线痴呆行为和心理症状（BPSD）严重程度进行了分析。美金刚单药治疗在治疗6个月前维持认知功能，但在12个月时出现下降（与基线相比，*p < 0.05）。然而，美金刚单药治疗在12个月前极大地改善了BPSD症状（*p < 0.05，**p < 0.01），并维持了其他情感功能以及日常生活活动能力。无论基线认知功能如何，美金刚治疗都显示出相似的效果，但对于基线认知功能较高的患者，对ABS的效果更好。美金刚治疗根据基线BPSD严重程度极大地改善了ABS。我们目前的OMS II研究表明，美金刚单药治疗在12个月前改善了BPSD。基线认知较高的亚组（MMSE≥15）和基线BPSD较差的亚组预计使用美金刚会有更好的效果。
