Department of Diagnostics and Applied Technology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
Neurol Sci. 2018 Jun;39(6):1021-1028. doi: 10.1007/s10072-018-3316-3. Epub 2018 Mar 17.
Alzheimer's disease (AD) can impair language, but active music therapy (AMT) and memantine (M) can improve communication. This study aimed to clarify whether adding AMT to M may improve language in comparison with drugs alone in patients with moderate AD on stable therapy with acetylcholinesterase inhibitors (AchEI). Forty-five AD patients treated with stable dose of AchEI were randomized to receive AMT plus M 20 mg/day or M 20 mg/day for 24 weeks. The Severe Impairment Battery-Language (SIB-l), SIB, Mini Mental State Examination, Neuropsychiatric Inventory (NPI), Lubben Social Network Scale, Activities of Daily Living, and Instrumental Activities of Daily Living scores at baseline and 12 and 24 weeks assessed language (primary variable) and overall cognitive, psycho-behavior, social, and functional aspects (secondary variables). The SIB-l showed a stabilization of the baseline condition in both groups, in the absence of between-group differences. The NPI depression and appetite scores significantly improved in the M-AMT group. Moreover, significantly less patients in the M-AMT group than those in the M group showed worsening of the NPI total score. Daily activities, social relationships, and overall cognitive performance did not deteriorate. In patients with moderate AD, AMT added to pharmacotherapy has no further benefits for language in comparison with pharmacotherapy alone. However, this integrated treatment can improve the psycho-behavioral profile.
阿尔茨海默病(AD)可损害语言能力,但积极的音乐治疗(AMT)和美金刚(M)可改善交流。本研究旨在阐明与单独使用药物相比,在接受乙酰胆碱酯酶抑制剂(AchEI)稳定治疗的中度 AD 患者中,添加 AMT 是否可以改善语言能力。45 名接受稳定剂量 AchEI 治疗的 AD 患者被随机分为接受 AMT 加 M 20mg/天或 M 20mg/天治疗 24 周。基线和 12 周、24 周时采用严重损害性电池语言测试(SIB-l)、SIB、简易精神状态检查、神经精神问卷(NPI)、卢本社会网络量表、日常生活活动和工具性日常生活活动评分评估语言(主要变量)和整体认知、心理行为、社会和功能方面(次要变量)。SIB-l 显示两组基线情况稳定,无组间差异。M-AMT 组的 NPI 抑郁和食欲评分显著改善。此外,与 M 组相比,M-AMT 组中出现 NPI 总分恶化的患者明显较少。日常生活活动、社会关系和整体认知表现没有恶化。在中度 AD 患者中,与单独药物治疗相比,药物治疗联合 AMT 对语言没有进一步的益处。然而,这种综合治疗可以改善心理行为特征。