Memantine is an NMDA (N-methyl D-aspartate) receptor antagonist currently used in the treatment of Alzheimer’s disease. NMDA receptors appear to mediate oligodendrocyte injury and damage to the myelin sheath, and Canadian researchers have speculated that blocking these receptors may be clinically useful in MS (Stys & Lipson. Trends Pharmacol Sci 2007; 28: 561-566).
Neurology
Effect of donepezil on apathy in Alzheimer’s disease
September 15, 2010Clinical trials in Alzheimer’s disease often do not include behavioural and psychological symptoms of dementia (BPSD) as a primary outcome. A systematic review of cholinesterase inhibitors (donepezil, rivastigmine, galantamine) in the management of BPSD noted that evidence was limited but concluded that pharmacologic interventions were warranted (Rodda et al. Int Psychogeriatr 2009; 21: 813-824).
SCT in Parkinson’s disease
September 15, 2010A small study has found that stem-cell transplantation is feasible and appears to be safe for the treatment of Parkinson’s disease, but a larger study is required to ascertain if it is effective (Venkataramana et al. Transl Res 2010; 155: 62-70).
Beta-interferon in MS: effect on long-term mortality
September 1, 2010A long-term follow-up analysis of patients enrolled in the pivotal trial of beta-interferon-1b reports that patients with relapsing-remitting MS in the active treatment arm have improved long-term mortality compared to patients in the placebo arm (Reder et al. Neurology 2010; 74: 1877-1885).
Treatment of nonmotor symptoms: AAN report
September 1, 2010The AAN Quality Standards subcommittee has issued its recommendations on the treatment of nonmotor symptoms in patients with Parkinson’s disease (Zesiewicz et al. Neurology 2010; 74: 924-931; free full text at www.neurology.org/cgi/reprint/74/11/924). Nonmotor symptoms addressed included sleep disorders (restless legs syndrome, periodic limb movements of sleep, excessive daytime somnolence, insomnia, REM sleep behaviour disorder), autonomic dysfunction (GI disorders, orthostatic hypotension, sexual dysfunction, urinary incontinence), fatigue and anxiety.