Effects of memantine treatment on language abilities and functional communication: A review of data

Abstract

Background: Impairment in language abilities occurs in a number of neurological conditions, including Alzheimer's disease (AD) and other dementias, primary progressive aphasia, multiple sclerosis and stroke. Currently, no pharmacotherapy is approved for aphasia of any aetiology. Memantine, an antagonist of N-methyl-D-aspartate glutamate receptors that is approved for the treatment of moderate-to-severe AD, has shown promising results on several measures of language and communication in clinical trials.

Aims: This review summarises the knowledge gathered from prospective studies and post hoc analyses involving patients with AD and other neurological conditions in whom the effects of memantine treatment on language or communication have been examined.

Main Contribution: PubMed searches yielded a total of four prospective studies and three post hoc analyses that assessed the effects of memantine on language and communication in AD (one additional post hoc analysis was published as a conference proceeding only), together with seven prospective studies in other conditions (Parkinson's disease, frontotemporal lobe degeneration, chronic post-stroke aphasia, primary progressive aphasia, multiple sclerosis, risk of dementia). Available data suggest that memantine provides modest language and communication benefits in patients with moderate-to-severe AD; potential benefits in Parkinson's disease and post-stroke aphasia were also observed.

Conclusions: Memantine may provide clinical benefits in language and communication in AD and other neurological conditions. Since communication problems create a significant burden for patients and their caregivers, larger prospective trials, conducted to provide more precise estimates of benefits in that domain, are merited.

Keywords:

• Memantine
• Alzheimer's disease
• Language
• Functional communication.

The authors wish to thank Torrey Volkman, Rebecca Myers, Mark Domke and Bill Sterling of Prescott Medical Communications Group, Chicago, IL for assistance with literature searches, checking of outlines and drafts for accuracy and consistency and creation of figures.

This study was sponsored by Forest Research Institute (FRI), a subsidiary of Forest Laboratories, Inc., the US marketer of memantine. Dr Saxton has received consulting fees from FRI for assistance in developing study MEM-MD-71, cited in this review. In addition, Dr Saxton received support from FRI for travel to meetings, and payments from H Lundbeck A/S (an international marketer of memantine) for lectures at company-sponsored symposia. Finally, Dr Saxton receives royalties from sales of the Severe Impairment Battery (SIB), a psychiatric assessment scale discussed in this review. Dr Bayles receives royalties from the sale of the Functional Linguistic Communication Inventory (FLCI), a communication test discussed in this review. Dr Lopez has served as a consultant for Lundbeck, Eli Lilly, Baxter and Merz Pharma, an international marketer of memantine. Drs Hofbauer and Tocco are employees of FRI and Drs Miller and Pejović are employees of Prescott Medical Communications Group, a paid consultant and medical communications contractor of FRI.