[Rivastigmine in a case of autopsy proved frontotemporal dementia (Pick's disease)].

Abstract

INTRODUCTION:

Cholinesterase inhibitors are useful in the treatment of behavioural and psychological symptoms in Alzheimer's disease. Their effectiveness in frontotemporal dementia has not been proved, since such a claim has only been backed by the publication of one open-label trial in which the behavioural and psychological symptoms of the patients treated with rivastigmine over a 12-month period improved significantly with respect to those belonging to a group that were given a placebo. We report a case of frontotemporal dementia, Pick's disease, which improved with rivastigmine treatment.

CASE REPORT:

A 61-year-old male who presented a progressive clinical picture of behavioural disorders and executive-cognitive impairment that had begun two years earlier. Magnetic resonance imaging of the head revealed severe frontotemporal atrophy. Neuropsychological Inventory (NPI). Overall score 36/144 (6/12: anxiety, disinhibition and aberrant motor behaviour, 4/12: agitation, irritability and apathy; 3/12: sleep and eating disorders. After three months' treatment with rivastigmine, the overall score on the NPI was 10/144. This improvement remained stable over the months that followed. The patient died eight months later after developing liver cancer with metastasis. The microscopic study of the brain showed tau-positive neuronal inclusions, gliosis and neuronal loss. The inclusions were well-circumscribed Pick bodies, which were present in the frontal and temporal cortices and in the dentate gyrus of the hippocampus.

CONCLUSIONS:

This case confirms the idea that treatment with cholinesterase inhibitors can be effective in the behavioural and psychological symptoms of frontotemporal dementia.

• Authors: T Calatayud-Noguera, A Astudillo-González, J C Alvarez-Carriles, T Temprano-Fernández, M Cortés-Velarde, P Oliva-Nacarino
• Journal: Revista de neurologia (Rev Neurol) 2009 Jun 1-15 Vol. 48 Issue 11 Pg. 582-4 ISSN: 1576-6578 [Electronic] Spain
• Vernacular Title: Rivastigmina en un caso de demencia frontotemporal, enfermedad de Pick verificada por autopsia.
• PMID: 19472156 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Cholinesterase Inhibitors
• Phenylcarbamates
• Rivastigmine

Topics

• Alzheimer Disease (drug therapy, physiopathology)
• Autopsy
• Brain (pathology)
• Cholinesterase Inhibitors (therapeutic use)
• Fatal Outcome
• Humans
• Male
• Middle Aged
• Phenylcarbamates (therapeutic use)
• Pick Disease of the Brain (drug therapy, pathology, physiopathology)
• Rivastigmine
• Treatment Outcome