Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA, USA.
VISN-22 Mental Illness, Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, USA.
J Alzheimers Dis. 2021;84(4):1431-1438. doi: 10.3233/JAD-215029.
Memantine's benefits in Alzheimer's disease (AD) are modest and heterogeneous. We tested the feasibility of using sensitivity to acute memantine challenge to predict an individual's clinical response. Eight participants completed a double-blind challenge study of memantine (placebo versus 20 mg) effects on autonomic, subjective, cognitive, and neurophysiological measures, followed by a 24-week unblinded active-dose therapeutic trial (10 mg bid). Study participation was well tolerated. Subgroups based on memantine sensitivity on specific laboratory measures differed in their clinical response to memantine, some by large effect sizes. It appears feasible to use biomarkers to predict clinical sensitivity to memantine.
美金刚在阿尔茨海默病(AD)中的疗效有限且存在异质性。我们测试了使用对急性美金刚挑战的敏感性来预测个体临床反应的可行性。8 名参与者完成了一项美金刚(安慰剂与 20mg)对自主神经、主观、认知和神经生理测量影响的双盲挑战研究,随后进行了 24 周的非盲活性剂量治疗试验(bid 10mg)。研究参与是可耐受的。基于特定实验室测量中美金刚敏感性的亚组在对美金刚的临床反应上存在差异,有些差异的效应量很大。使用生物标志物预测对美金刚的临床敏感性似乎是可行的。