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Effects of memantine on clinical ratings, fluorodeoxyglucose positron emission tomography measurements, and cerebrospinal fluid assays in patients with moderate to severe Alzheimer dementia: a 24-week, randomized, clinical trial
Wang T, Huang Q, Reiman EM, Chen K, Li X, Li G, Lin Z, Li C et al.. Journal of clinical psychopharmacology, 2013-10-01
Topic: Amyloid, tau and blood-test diagnosis
Most experts consider that memantine has a symptomatic treatment, but clinical trials have not yet provided compelling evidence to support a disease-modifying effect. We investigate the effects of memantine on clinical ratings; fluorodeoxyglucose positron emission tomography (FDG-PET) measurements, which can monitor disease-modifying effect; and cerebrospinal fluid (CSF) assays in patients with moderate to severe probable Alzheimer disease (AD) dementia. Twenty-two patients completed a 24-week, double-blind, placebo-controlled, randomized clinical trial of memantine, titrated up to 10 mg twice per day using the Severe Impairment Battery, AD Assessment Scale-Cognitive subscale, Mini-Mental State Examination, FDG-PET measurements of the regional cerebral metabolic rate for glucose (CMRgl), and CSF amyloid β (Aβ) and tau assays. An automated brain mapping algorithm and predefined regions of interest were each used to analyze treatment-related regional CMRgl effects. In comparison with the placebo group, the memantine treatment group had significantly less cognitive decline on the Severe Impairment Battery and significantly less CMRgl declines in regions preferentially affected by AD. There were no significant treatment effects on CSF Aβ₁₋₄₂, CSF Aβ₁₋₄₀, total tau, or phosphor-tau levels or ratios. This relatively small and brief randomized clinical trial suggests an association between memantine's clinical benefit and its effects on FDG-PET measurements in AD-affected brain regions. Larger and longer studies are needed to confirm these findings, extend them to earlier clinical and preclinical stages of AD, and help determine the extent to which FDG-PET should be qualified for use as a reasonably likely surrogate end point in the evaluation of putative AD-modifying treatments.
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APA 7th
Wang, T., Huang, Q., Reiman, E. M., Chen, K., Li, X., Li, G., et al. (2013). Effects of memantine on clinical ratings, fluorodeoxyglucose positron emission tomography measurements, and cerebrospinal fluid assays in patients with moderate to severe Alzheimer dementia: a 24-week, randomized, clinical trial. Journal of clinical psychopharmacology. https://doi.org/10.1097/jcp.0b013e31829a876a
Vancouver
Wang T, Huang Q, Reiman EM, Chen K, Li X, Li G, et al. Effects of memantine on clinical ratings, fluorodeoxyglucose positron emission tomography measurements, and cerebrospinal fluid assays in patients with moderate to severe Alzheimer dementia: a 24-week, randomized, clinical trial. Journal of clinical psychopharmacology. 2013. doi:10.1097/jcp.0b013e31829a876a. PMID: 23948786.
BibTeX
@article{wang2013-23948786,
author = {Wang, T. and Huang, Q. and Reiman, E. M. and Chen, K. and Li, X. and Li, G. and Lin, Z. and Li, C. and others},
title = {{Effects of memantine on clinical ratings, fluorodeoxyglucose positron emission tomography measurements, and cerebrospinal fluid assays in patients with moderate to severe Alzheimer dementia: a 24-week, randomized, clinical trial}},
journal = {Journal of clinical psychopharmacology},
year = {2013},
doi = {10.1097/jcp.0b013e31829a876a},
pmid = {23948786},
url = {https://doi.org/10.1097/jcp.0b013e31829a876a}
}
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Key findings
- In comparison with the placebo group, the memantine treatment group had significantly less cognitive decline on the Severe Impairment Battery and significantly less CMRgl declines in regions preferentially affected by AD.
- There were no significant treatment effects on CSF Aβ₁₋₄₂, CSF Aβ₁₋₄₀, total tau, or phosphor-tau levels or ratios.
- Larger and longer studies are needed to confirm these findings, extend them to earlier clinical and preclinical stages of AD, and help determine the extent to which FDG-PET should be qualified for use as a reasonably likely surrogate end point in the evaluation of putative AD-modifying treatments.
Why it matters
In this small trial, people with moderate to severe Alzheimer disease treated with memantine showed less cognitive decline and less decline in brain glucose metabolism than those on placebo, but there were no significant effects on cerebrospinal fluid markers. The authors note that larger and longer studies are needed, and this does not establish a disease-modifying effect.
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Study details
- Evidence strengthHigh
How this study scored 56/100
Published in a peer-reviewed journal, and it is a randomised controlled trial. Scored zero for sample size and effect reported because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of clinical psychopharmacology) |
| Journal's citation record | 2 / 4 | Journal of Clinical Psychopharmacology: journal h-index 163 (OpenAlex, 2026-10-29) |
| Study design | 11 / 12 | A randomised controlled trial (from PubMed type “Randomized Controlled Trial”) |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2013 — within 20 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (pubmed indexes it as a clinical or observational study) |
| Randomised / blinded | 2 / 2 | Randomised and blinded or placebo-controlled (as stated in the record) |
| Times cited | 3 / 7 | Cited 32 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 2.1 citations a year over 15 year(s) since 2013 |
| Impact for its field and year | 2 / 6 | Cited 1.8× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 2 other studies in this library |
| Still being cited | 1 / 4 | Cited 4 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Shifu Xiao: h-index 38 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University of Arizona: institution h-index 1,336 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 6 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 23948786) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 56 / 100 | — |
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