Intervention Review

Memantine for dementia in people with Down syndrome

  1. Monica Mohan1,*,
  2. Cathy Bennett2,
  3. Peter K Carpenter3

Editorial Group: Cochrane Developmental, Psychosocial and Learning Problems Group

Published Online: 21 JAN 2009

Assessed as up-to-date: 29 OCT 2008

DOI: 10.1002/14651858.CD007657


How to Cite

Mohan M, Bennett C, Carpenter PK. Memantine for dementia in people with Down syndrome. Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No.: CD007657. DOI: 10.1002/14651858.CD007657.

Author Information

  1. 1

    The Burden Centre, Department of Neuropsychiatry, Neuropsychology and Epileptology, Bristol, Avon, UK

  2. 2

    University of Leeds, Cochrane UGPD Group, Leeds, West Yorkshire, UK

  3. 3

    Bath and North Somerset PCT, Department of Learning Disability, Bristol, UK

*Monica Mohan, Department of Neuropsychiatry, Neuropsychology and Epileptology, The Burden Centre, The North Bristol Trust, Frenchay Hospital, Bristol, Avon, BS16 1JB, UK. drmonicamohan@yahoo.co.uk .

Publication History

  1. Publication Status: New
  2. Published Online: 21 JAN 2009

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Alzheimer's dementia (AD) is the most common form of dementia in people with Down Syndrome (DS). There is an understanding that an increase in L-glutamate contributes to the pathogenesis of cerebral ischemias and AD. Memantine acts as an antagonist of N-methyl-D-aspartate (NMDA) type receptors, which is thought to reduce abnormal activation of glutamate neurotransmission. It binds with a low affinity to the NMDA receptor and so should not prevent learning and the formation of memory. Memantine can improve cognitive function and slow the decline of AD in the general population over time, and is the subject of this review. It is important to note that people with DS tend to present with AD at a much younger age than the normal population as well as having subtle differences in physiology (e.g. metabolism and heart rate) and may therefore have different requirements from the general population.

Objectives

To determine the effectiveness and safety of memantine for people with DS who develop AD.

Search methods

CENTRAL, MEDLINE, EMBASE, CINAHL, PsycINFO, BIOSIS, SCI, SSCI and the NRR were searched up to October 2008. We contacted the manufacturers of memantine, as well as experts in the field, to ask about reports of unpublished or ongoing trials.

Selection criteria

Randomised controlled trials of participants with DS and AD in which treatment with memantine was administered compared with a placebo group.

Data collection and analysis

No study was identified which met the inclusion criteria for this review.

Main results

No study was identified which met inclusion criteria for this review, however there is an on-going randomised controlled study being conducted in the UK and data are expected in 2009.

Authors' conclusions

As there are no included trials, recommendations cannot be made about memantine for AD in DS. Well-designed, adequately powered studies are required.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Memantine for dementia in people with Down syndrome

Memantine is thought to improve cognitive function and slow the decline of AD over time.The effects of memantine on AD are reported to be beneficial for people with moderate to severe AD in the general population, However, people with DS tend to present with AD at a much younger age than the general population as well as being physically different in terms of size, metabolism and heart rate, and may therefore have different requirements. Results from the one randomised controlled trial for the treatment of dementia in DS are not yet available (expected 2009).

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

Memantine在患唐氏症 (Down syndrome) 的失智症患者之使用

阿茲海默症 (Alzheimer's dementia) 是唐氏症患者中最常見的失智症種類。目前了解,Lglutamate的增加是大腦缺血和阿茲海默症的病因之一。Memantine作用為NmethylDaspartate (NMDA) 受器的拮抗劑,被認為可以減少glutamate神經傳導不正常的活化。它和NMDA受器為低親合力結合,所以應該不會妨礙學習和記憶的形成。Memantine在一般族群中,可用來改善認知功能,減緩阿茲海默症的惡化,為這篇回顧探討的主題。重要的是,唐氏症患者比起一般族群,阿茲海默症的發生有年輕化的傾向,而且在一些生理反應上 (例如,代謝和心跳速率) 也有些微差異,因此比起一般族群可能有不同的需求。

目標

決定memantine對有失智症的唐氏症患者,治療的效果和安全性。

搜尋策略

搜尋CENTRAL,MEDLINE,EMBASE,CINAHL,PsycINFO,BIOSIS,SCI,SSCI和NRR直到2008年10月的資料。另外,我們連絡memantine的製造商,和相關領域的專家,詢問尚未發表或還在進行中的試驗。

選擇標準

比較以memantine和安慰劑,來治療合併唐氏症與阿茲海默症患者的隨機分布試驗。

資料收集與分析

這篇回顧並沒有找到符合選擇標準的試驗。

主要結論

沒有試驗符合這篇回顧的選擇標準,然而在英國有一篇正在進行中的隨機分布試驗,可望在2009年有資料呈現。

作者結論

既然沒有符合的試驗,對於memantine治療唐氏症患者的阿茲海默症方面,沒有辦法作出建議。需要進一步良好設計,有足夠效力的試驗。

翻譯人

本摘要由成功大學附設醫院紀美宏翻譯。

此翻譯計畫由臺灣國家衛生研究院 (National Health Research Institutes, Taiwan) 統籌。

總結

唐氏症 (Down syndrome) 患者的失智症病人,memantine之使用: Memantine可用來改善認知功能,減緩阿茲海默症的惡化。對於一般族群,memantine的功效益處主要針對中度到重度的阿茲海默症患者。然而,唐氏症患者發生阿茲海默症的年齡更為年輕,另外在生理上,包括大小,代謝和心跳速率,也都有差異,所以可能有不同的需求。關於治療的隨機分布試驗結果尚未被報告 (可望在2009年提出) 。