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美金刚治疗帕金森病痴呆的长期疗效:一项为期18个月的前瞻性灌注单光子发射计算机断层扫描初步研究。

Long-Term Efficacy of Memantine in Parkinson' Disease Dementia: An 18-Month Prospective Perfusion Single Photon Emission Computed Tomography Preliminary Study.

作者信息

Jeong Hyeonseok S, Chung Yong-An, Park Jong-Sik, Song In-Uk, Yang YoungSoon

机构信息

Department of Nuclear Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea.

Department of Neurology, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea.

出版信息

Dement Neurocogn Disord. 2016 Jun;15(2):43-48. doi: 10.12779/dnd.2016.15.2.43. Epub 2016 Jun 30.

Abstract

BACKGROUND AND PURPOSE

Although the treatment efficacy of memantine in Parkinson's disease dementia (PDD) has been reported after several weeks of administration, the long-term effects on brain perfusion and clinical symptoms remain unclear. The current study aimed to follow-up PDD patients after 18 months of memantine treatment using Tc hexamethylpropylene amine oxime single photon emission computed tomography (SPECT).

METHODS

A total of 15 patients with PDD and 11 healthy participants were recruited into this study and they were assessed with brain SPECT, Mini-Mental State Examination (MMSE), Clinical Dementia Rating (CDR), Global Deterioration Scale (GDS), and Neuropsychiatric Inventory (NPI). Differences in regional cerebral blood flow (rCBF) between the two groups were evaluated at baseline. After 18 months of memantine administration, changes in brain perfusion, severity of dementia, cognition, and neuropsychiatric disturbances were examined in the patients with PDD.

RESULTS

The PDD group showed hypoperfusion in most of the cortical, subcortical, and cerebellar areas compared to healthy controls at baseline. At the follow-up, changes in rCBF, CDR (=0.32), sum of box of CDR (=0.49), MMSE (=0.61), GDS (=0.79), and NPI (=0.23) were not significant in the PDD patients.

CONCLUSIONS

Our findings implicate that memantine may delay the progression of brain perfusion deficits and clinical symptoms of PDD in the long term.

摘要

背景与目的

尽管已有报道称美金刚在帕金森病痴呆(PDD)患者给药数周后具有治疗效果,但其对脑灌注和临床症状的长期影响仍不明确。本研究旨在使用锝六甲基丙烯胺肟单光子发射计算机断层扫描(SPECT)对接受美金刚治疗18个月后的PDD患者进行随访。

方法

本研究共纳入15例PDD患者和11名健康参与者,对他们进行脑SPECT、简易精神状态检查表(MMSE)、临床痴呆评定量表(CDR)、总体衰退量表(GDS)和神经精神科问卷(NPI)评估。在基线时评估两组之间局部脑血流量(rCBF)的差异。在给予美金刚18个月后,对PDD患者的脑灌注变化、痴呆严重程度、认知和神经精神障碍进行检查。

结果

与健康对照组相比,PDD组在基线时大多数皮质、皮质下和小脑区域存在灌注不足。在随访时,PDD患者的rCBF、CDR(=0.32)、CDR框总和(=0.49)、MMSE(=0.61)、GDS(=0.79)和NPI(=0.23)变化不显著。

结论

我们的研究结果表明,美金刚可能长期延缓PDD患者脑灌注缺陷和临床症状的进展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b0e/6427978/c768d6c72872/dnd-15-43-g001.jpg

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