Case of Pick's Central Lobar Atrophy With Apparent Stabilization of Cognitive Decline After Treatment With Risperidone

Curtis, Rod; Resch, David S.

doi:10.1097/00004714-200006000-00018

Cited by 53 publications

(30 citation statements)

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“…59 The mechanism with which these medications reduce agitation is not fully understood. A case report 60 with risperidone and an open-label uncontrolled study 61 of olanzapine support the use of these medications in FTD. The reduction in the NPI observed with olanzapine treatment was similar in magnitude to that observed with antidepressant treatment (see table E-2).…”

Section: Treatment Reviewmentioning

confidence: 81%

A systematic review of neurotransmitter deficits and treatments in frontotemporal dementia

2006

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Objective-To evaluate neurotransmitter deficiencies and neurotransmitter-based treatments for frontotemporal dementia (FTD).Methods-The authors conducted a systematic review of the literature on the mechanism and treatment of FTD and a meta-analysis of treatment studies of antidepressants for the behavioral symptoms of FTD.Results-Patients with FTD show deficiencies in the serotonin and dopamine neurotransmitter systems, while the acetylcholine system appears relatively intact. Antidepressant treatment significantly improves behavioral symptoms in FTD, but most studies are small and uncontrolled. Serotonergic treatments appear to improve the behavioral but not cognitive symptoms of FTD.Conclusions-Studies of neurotransmitter deficiencies in frontotemporal dementia (FTD) can be helpful in developing treatments. Treatment studies on FTD are scarce, given the prevalence and severity of this illness. Larger, well-controlled treatment studies are required to reach more definitive conclusions about treatment efficacy. Multicenter studies are likely the best way to complete treatment studies in a timely manner.Frontotemporal dementia (FTD) is increasingly recognized as an important cause of dementia. 1 The symptoms of FTD include behavioral symptoms such as disinhibition, inappropriate social behavior, and apathy. Other symptoms include language and executive dysfunction. 2,3 The behavioral symptoms of FTD can be difficult to manage for caregivers and clinicians.The paucity of pharmacologic trials for FTD is likely due to the only recent clinical definition of the illness, limitations in understanding the biology of FTD, and the difficulty of assembling well-characterized groups of patients.

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Section: Treatment Reviewmentioning

confidence: 81%

A systematic review of neurotransmitter deficits and treatments in frontotemporal dementia

2006

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“…The largest sample comprised 49 patients 12 and seven studies were single-case reports. [13][14][15][16][17][18][19] Nine studies did not define the subtype of FTLD analyzed (n = 124). Among the studies that defined the FTLD subtypes, the behavioral variant was the most common (n = 202), followed by progressive non-fluent aphasia (n = 38) and semantic dementia (n = 25).…”

Section: Resultsmentioning

confidence: 99%

“…37 Another seven studies noted improvement in behavior although not statistically significant. [14][15][16]18,19,38,39 As for efficacy in cognition, two studies showed no change, 14,37 whereas four others reported a clinical improvement, also not statistically significant. 13,17,38,40 Overall, we found that 1/3 of the studies reported significant improvement in behavior symptoms with SSRI, 1/3 showed clinical but not statistically significant changes and 1/6 showed no differences from baseline evaluation.…”

Section: Resultsmentioning

confidence: 99%

Pharmacological treatment of frontotemporal lobar degeneration: systematic review

Portugal

Marinho

Laks

2011

Rev. Bras. Psiquiatr.

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Objective: To identify the therapeutic options available for treatment of cognitive and behavioral symptoms in frontotemporal lobar degeneration. Method: Systematic review using the descriptors "frontotemporal lobar degeneration" OR "frontotemporal dementia" OR "fronto-temporal dementia" OR "fronto-temporal degeneration" OR "Pick's disease" OR "Pick's atrophy" OR "semantic dementia" OR "progressive aphasia" AND "pharmacotherapy" OR "treatment" OR "efficacy" OR "effects" OR "management" was performed in the Medline and Lilacs databases. Selection criteria: Quality A -randomized clinical trials. Quality Bopen studies or reports of six or more cases. Quality C -reports of five or fewer cases. Two reviewers independently assessed the clinical studies. Information collected included diagnostic criteria used, sample size, duration, efficacy and tolerability measures used and results obtained. Results: From the 532 studies found, 29 complied with the inclusion criteria. All studies worked with a small sample, had short duration of treatment and used non-uniform measures in evaluating efficacy and tolerability. Studies showed disparate results with respect to behavior and cognition. Conclusion: There is still little, and poor, evidence available for treatment of frontotemporal lobar degeneration and studies with better methodological background are needed. Descriptors IntroductionThe clinical syndromes related to frontotemporal lobar degeneration (FTLD) are the second most common cause of pre-senile primary dementia. 1 A recent Brazilian epidemiological study found a dementia prevalence of 7.1% in individuals over

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“…[86][87][88][89] Despite the lack of scientific evidence, atypical antipsychotics have also been used to treat FTD symptoms, especially agitation and disinhibition. The literature describes one case treated with risperidone 90 and an open trial with olanzapine that favours use of the drug. 91 Other dopaminergic agents, such as selegiline (IMAO-B), 92 have been used successfully to reduce neuropsychiatric symptoms.…”

Section: Treatmentmentioning

confidence: 99%

Behavioural variant frontotemporal dementia: Clinical and therapeutic approaches

Fernández‐Matarrubia

Matías‐Guiu

Moreno‐Ramos

2014

Neurología (English Edition)

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Introduction: Behavioural variant frontotemporal dementia (bvFTD) is the most frequent presentation in the clinical spectrum of frontotemporal dementia (FTD) and it is characterised by progressive changes in personality and conduct. Major breakthroughs in molecular biology and genetics made during the last two decades have lent us a better understanding of this syndrome, which may be the first manifestation in many different neurodegenerative diseases. Development:We reviewed the main epidemiological, clinical, diagnostic and therapeutic aspects of bvFTD. Most cases manifest sporadically and the average age of onset is 58 years. Current criteria for bvFTD propose three levels of diagnostic certainty: possible, probable, and definite. Clinical diagnosis is based on a detailed medical history provided by family members and caregivers, in conjunction with neuropsychological testing. Treatments which have been used in bvFDT to date are all symptomatic and their effectiveness is debatable. New drugs designed for specific molecular targets that are implicated in frontotemporal lobar degeneration are being developed.Conclusions: BvFDT is a frequent cause of dementia. It is a non-specific syndrome associated with heterogeneous histopathological and biomolecular findings. The definition of clinical subtypes complemented by biomarker identification may help predict the underlying pathology. This knowledge, along with the development of drugs designed for molecular targets, will offer new treatment possibilities. Demencia frontotemporal variante conductual; Degeneración lobar frontotemporal; Clínica; Diagnóstico; Criterios diagnósticos; Tratamiento Demencia frontotemporal variante conductual: aproximación clínica y terapéutica Resumen Introducción: La variante conductual de la demencia frontotemporal (DFT vc) es el síndrome clínico más frecuente de las demencias frontotemporales (DFT) y se caracteriza por una alteración progresiva de la personalidad y la conducta. En las últimas 2 décadas, los avances en biología molecular y genética han contribuido a un mayor conocimiento de esta entidad, que puede ser el modo de presentación de diferentes enfermedades neurodegenerativas.Desarrollo: Se revisan los principales aspectos epidemiológicos, clínicos, diagnósticos y terapéuticos de la DFT vc. La mayoría de los casos son esporádicos, iniciándose en torno a los 58 años de media. Los criterios diagnósticos vigentes establecen 3 niveles de certeza diagnós-tica: posible, probable y definitivo. El diagnóstico clínico se basa en la anamnesis detallada de familiares, complementada con la realización de test neuropsicológicos dirigidos. Hasta la fecha, los tratamientos empleados son solo sintomáticos y de eficacia controvertida. Se están diseñando fármacos dirigidos contra dianas moleculares específicas implicadas en la patogenia de las degeneraciones lobares frontotemporales.Conclusiones: La DFT vc es una causa frecuente de demencia. Se trata de un síndrome amplio, heterogéneo desde el punto de vista histopatológico y biomolecular. La de...

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Case of Pick's Central Lobar Atrophy With Apparent Stabilization of Cognitive Decline After Treatment With Risperidone

Cited by 53 publications

References 5 publications

A systematic review of neurotransmitter deficits and treatments in frontotemporal dementia

A systematic review of neurotransmitter deficits and treatments in frontotemporal dementia

Pharmacological treatment of frontotemporal lobar degeneration: systematic review

Behavioural variant frontotemporal dementia: Clinical and therapeutic approaches

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