Tetrahydrocannabinol for neuropsychiatric symptoms in dementia: A randomized controlled trial.

Abstract:

OBJECTIVE:To study the efficacy and safety of low-dose oral tetrahydrocannabinol (THC) in the treatment of dementia-related neuropsychiatric symptoms (NPS). METHODS:This is a randomized, double-blind, placebo-controlled study. Patients with dementia and clinically relevant NPS were randomly assigned to receive THC 1.5 mg or matched placebo (1:1) 3 times daily for 3 weeks. Primary outcome was change in Neuropsychiatric Inventory (NPI), assessed at baseline and after 14 and 21 days. Analyses were based on intention-to-treat. RESULTS:Twenty-four patients received THC and 26 received placebo. NPS were reduced during both treatment conditions. The difference in reduction from baseline between THC and placebo was not significant (mean difference NPItotal: 3.2, 95% confidence interval [CI] -3.6 to 10.0), nor were changes in scores for agitation (Cohen-Mansfield Agitation Inventory 4.6, 95% CI -3.0 to 12.2), quality of life (Quality of Life-Alzheimer's Disease -0.5, 95% CI -2.6 to 1.6), or activities of daily living (Barthel Index 0.6, 95% CI -0.8 to 1.9). The number of patients experiencing mild or moderate adverse events was similar (THC, n = 16; placebo, n = 14, p = 0.36). No effects on vital signs, weight, or episodic memory were observed. CONCLUSIONS:Oral THC of 4.5 mg daily showed no benefit in NPS, but was well-tolerated, which adds valuable knowledge to the scarce evidence on THC in dementia. The benign adverse event profile of this dosage allows study of whether higher doses are efficacious and equally well-tolerated. CLASSIFICATION OF EVIDENCE:This study provides Class I evidence that for patients with dementia-related NPS, low-dose THC does not significantly reduce NPS at 21 days, though it is well-tolerated.

journal_name

Neurology

journal_title

Neurology

authors

van den Elsen GA,Ahmed AI,Verkes RJ,Kramers C,Feuth T,Rosenberg PB,van der Marck MA,Olde Rikkert MG

doi

10.1212/WNL.0000000000001675

subject

Has Abstract

pub_date

2015-06-09 00:00:00

pages

2338-46

issue

23

eissn

0028-3878

issn

1526-632X

pii

WNL.0000000000001675

journal_volume

84

pub_type

杂志文章,多中心研究,随机对照试验
  • Acute hydrocephalus in nonketotic hyperglycinemia.

    abstract::We present four patients with typical neonatal onset non-ketotic hyperglycinemia (NKH) who developed hydrocephalus requiring shunting in early infancy. Brain imaging revealed acute hydrocephalus, a megacisterna magna or posterior fossa cyst, pronounced atrophy of the white matter, and an extremely thin corpus callosum...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.54.3.754

    authors: Van Hove JL,Kishnani PS,Demaerel P,Kahler SG,Miller C,Jaeken J,Rutledge SL

    更新日期:2000-02-08 00:00:00

  • Localizing value of torsional nystagmus in small midbrain lesions.

    abstract:BACKGROUND:The topodiagnostic value and specificity of nystagmus in patients with mesencephalic lesions and its relation to tonic torsional deficits and vertical saccade deficits is controversial and anecdotal. METHODS:The authors examined 11 patients with vascular MRI-identified mesencephalic lesions and clinical evi...

    journal_title:Neurology

    pub_type: 临床试验,杂志文章

    doi:10.1212/01.wnl.0000038387.90128.8d

    authors: Helmchen C,Rambold H,Kempermann U,Büttner-Ennever JA,Büttner U

    更新日期:2002-12-24 00:00:00

  • Treatable neurotransmitter deficiency in mild phenylketonuria.

    abstract::The authors describe a case of neurologic involvement in mild hyperphenylalaninemia (HPA), not due to tetrahydrobiopterin (BH(4)) deficiency, with low levels of monoamine neurotransmitter metabolites in CSF. The combined BH(4)-Phe loading test suggested a BH(4) response, confirmed by clinical improvement after BH(4) t...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.57.5.908

    authors: Bonafé L,Blau N,Burlina AP,Romstad A,Güttler F,Burlina AB

    更新日期:2001-09-11 00:00:00

  • Caregivers' preferences for the treatment of patients with Alzheimer's disease.

    abstract:OBJECTIVES:To learn caregivers' preferences for the treatment of AD with a disease-slowing therapy, and to identify relationships between these preferences and the characteristics of caregivers and patients. METHODS:A structured interview with 40 caregivers of patients with AD. Preferences were measured for an AD-slow...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.55.7.1008

    authors: Karlawish JH,Klocinski JL,Merz J,Clark CM,Asch DA

    更新日期:2000-10-10 00:00:00

  • Hemispatial visual inattention masquerading as hemianopia.

    abstract::The defect occurring when a patient fails to report a visual stimulus presented in a visual half-field may be attributed to hemianopia (deafferentation) caused by a geniculocalcarine lesion. However, failure to report a stimulus presented in a visual field may also be caused by hemispatial visual inattention. We repor...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.39.8.1125

    authors: Kooistra CA,Heilman KM

    更新日期:1989-08-01 00:00:00

  • Acetaminophen sulfation in patients with Parkinson's disease or Huntington's disease is not impaired.

    abstract::We studied acetaminophen sulfation, plasma sulfate levels, and the activity of sulfotransferase in blood platelets in patients with Parkinson's disease, Huntington's disease, and in controls and did not find any abnormality in the patient groups, independent of the use of medication. ...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.43.7.1373

    authors: Roos RA,Steenvoorden JM,Mulder GJ,Van Kempen GM

    更新日期:1993-07-01 00:00:00

  • Improvement in multiple sclerosis during prolonged induced hypothermia.

    abstract::Moderate hypothermia (33 degrees C) was induced for 7 and 3 days, respectively, in two patients with multiple sclerosis. In both patients, striking improvement of clinical signs persisted throughout the period of cooling, indicating the potential for sustained reversal of the neurologic deficit. Hypothermia may aid ma...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.27.3.302

    authors: Symington GR,Mackay IR,Currie TT

    更新日期:1977-03-01 00:00:00

  • CT angiography spot sign in intracerebral hemorrhage predicts active bleeding during surgery.

    abstract:OBJECTIVE:To determine whether the CT angiography (CTA) spot sign marks bleeding complications during and after surgery for spontaneous intracerebral hemorrhage (ICH). METHODS:In a 2-center study of consecutive spontaneous ICH patients who underwent CTA followed by surgical hematoma evacuation, 2 experienced readers (...

    journal_title:Neurology

    pub_type: 杂志文章,多中心研究

    doi:10.1212/WNL.0000000000000747

    authors: Brouwers HB,Raffeld MR,van Nieuwenhuizen KM,Falcone GJ,Ayres AM,McNamara KA,Schwab K,Romero JM,Velthuis BK,Viswanathan A,Greenberg SM,Ogilvy CS,van der Zwan A,Rinkel GJ,Goldstein JN,Klijn CJ,Rosand J

    更新日期:2014-09-02 00:00:00

  • Galantamine in AD: A 6-month randomized, placebo-controlled trial with a 6-month extension. The Galantamine USA-1 Study Group.

    abstract:BACKGROUND:Galantamine is a reversible, competitive cholinesterase inhibitor that also allosterically modulates nicotinic acetylcholine receptors. These mechanisms of action provided the rationale for a therapeutic trial of galantamine in AD. METHODS:A 6-month, multicenter, double-blind trial was undertaken in 636 pat...

    journal_title:Neurology

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1212/wnl.54.12.2261

    authors: Raskind MA,Peskind ER,Wessel T,Yuan W

    更新日期:2000-06-27 00:00:00

  • Acoustic reflex abnormalities in cranial-cervical dystonia.

    abstract::Previous anatomic and physiologic studies suggest brainstem dysfunction in cranial-cervical dystonia. To further explore this, we studied suprathreshold acoustic reflex waveforms in 15 such patients. A unique feature of this technique is its ability to reject movement artifacts before averaging the acoustic reflex wav...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.42.3.594

    authors: Lew H,Jordan C,Jerger J,Jankovic J

    更新日期:1992-03-01 00:00:00

  • Diagnosis and misdiagnosis of adult neuronal ceroid lipofuscinosis (Kufs disease).

    abstract:OBJECTIVE:To critically re-evaluate cases diagnosed as adult neuronal ceroid lipofuscinosis (ANCL) in order to aid clinicopathologic diagnosis as a route to further gene discovery. METHODS:Through establishment of an international consortium we pooled 47 unsolved cases regarded by referring centers as ANCL. Clinical a...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0000000000002943

    authors: Berkovic SF,Staropoli JF,Carpenter S,Oliver KL,Kmoch S,Anderson GW,Damiano JA,Hildebrand MS,Sims KB,Cotman SL,Bahlo M,Smith KR,Cadieux-Dion M,Cossette P,Jedličková I,Přistoupilová A,Mole SE,ANCL Gene Discovery Consortiu

    更新日期:2016-08-09 00:00:00

  • Pontine anosognosia for hemiplegia.

    abstract::Four patients had anosognosia for hemiplegia (AHP) as a manifestation of pontine infarction in the mediolateral region. Patients with AHP syndrome had no mental and neuropsychologic disturbances, and all had involvement of the medial or lateral part of the pons (medial or lateral pontine reticular nuclei). Brainstem l...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.53.3.647

    authors: Evyapan D,Kumral E

    更新日期:1999-08-11 00:00:00

  • Familial hemiplegic migraine versus migraine with prolonged aura: an uncertain diagnosis in a family report.

    abstract::Four of five members of a family complained of repeated attacks of hemiplegic migraine, migraine with aura of different types, or migraine without aura. The hemiplegia always outlasted the headache and was often accompanied by altered consciousness, aphasia, and, in one patient, coma; in this latter patient, the ictal...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.45.1.33

    authors: Marchioni E,Galimberti CA,Soragna D,Ferrandi D,Maurelli M,Ratti MT,Bo P,Montalbetti L,Albergati A,Savoldi F

    更新日期:1995-01-01 00:00:00

  • Fatigue in Parkinson's disease.

    abstract::Fatigue is a common but poorly understood symptom in Parkinson's disease (PD). Using previously validated scales, we asked 58 nondemented PD patients and 58 controls to fill out questionnaires assessing fatigue and depression and found that PD patients were more depressed and more fatigued than age-matched controls. A...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.43.10.2016

    authors: Friedman J,Friedman H

    更新日期:1993-10-01 00:00:00

  • Coccidioidal meningitis and brain abscesses: analysis of 71 cases at a referral center.

    abstract:OBJECTIVE:Coccidioides species are the most common etiologic agents of chronic meningitis in regions endemic for coccidioidomycosis. Occasionally, even short-term travel to endemic regions results in the acquisition of meningeal disease, so awareness of this complication of coccidioidomycosis is important even in nonen...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0b013e3181c34b69

    authors: Drake KW,Adam RD

    更新日期:2009-11-24 00:00:00

  • Resective reoperation for failed epilepsy surgery: seizure outcome in 64 patients.

    abstract:OBJECTIVE:To determine the surgical outcome and factors of predictive value in patients undergoing reoperation for intractable partial epilepsy. METHODS:The authors retrospectively studied the operative outcome in 64 consecutive patients who underwent reoperation for intractable partial epilepsy. Demographic data, res...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/01.wnl.0000147476.86575.a7

    authors: Siegel AM,Cascino GD,Meyer FB,McClelland RL,So EL,Marsh WR,Scheithauer BW,Sharbrough FW

    更新日期:2004-12-28 00:00:00

  • Intensity dependence of auditory evoked potentials is pronounced in migraine: an indication of cortical potentiation and low serotonergic neurotransmission?

    abstract::Migraine is associated with stimulus hypersensitivity, increased evoked cortical responses, and abnormal 5-HT levels in peripheral blood. We studied cortical auditory evoked potentials (AEPs) between attacks in 35 patients suffering from migraine without aura (MO, n = 25) or with aura (MA, n = 10) and in 25 healthy vo...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.46.5.1404

    authors: Wang W,Timsit-Berthier M,Schoenen J

    更新日期:1996-05-01 00:00:00

  • Mixed-location cerebral hemorrhage/microbleeds: Underlying microangiopathy and recurrence risk.

    abstract:OBJECTIVE:To assess the predominant type of cerebral small vessel disease (SVD) and recurrence risk in patients who present with a combination of lobar and deep intracerebral hemorrhage (ICH)/microbleed locations (mixed ICH). METHODS:Of 391 consecutive patients with primary ICH enrolled in a prospective registry, 75 (...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0000000000004797

    authors: Pasi M,Charidimou A,Boulouis G,Auriel E,Ayres A,Schwab KM,Goldstein JN,Rosand J,Viswanathan A,Pantoni L,Greenberg SM,Gurol ME

    更新日期:2018-01-09 00:00:00

  • Is there a neurologist on this flight?

    abstract:OBJECTIVE:To analyze the frequency of neurologic events during commercial airline flights and to assess whether onboard emergency medical kits are adequate for in-flight neurologic emergencies. METHODS:Collaboration of the Mayo Clinic's Departments of Emergency Medicine and Medical Transportation Service and the Divis...

    journal_title:Neurology

    pub_type: 杂志文章,评审

    doi:10.1212/wnl.58.12.1739

    authors: Sirven JI,Claypool DW,Sahs KL,Wingerchuk DM,Bortz JJ,Drazkowski J,Caselli R,Zanick D

    更新日期:2002-06-25 00:00:00

  • Teaching Video NeuroImages: myokymia and nerve hyperexcitability as components of Morvan syndrome due to malignant thymoma.

    abstract::A 50-year-old woman with a history of metastatic malignant thymoma presented with diffuse neuropathic pain involving the extremities and torso prior to chemotherapy and radiation. She also developed episodic diarrhea, diaphoresis, fevers, insomnia, and encephalopathy. Examination revealed rippling muscles (video on th...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0b013e31827f0fa1

    authors: Lukas RV,Rezania K,Malec M,Salgia R

    更新日期:2013-01-29 00:00:00

  • Genetics of epilepsy: The testimony of twins in the molecular era.

    abstract:OBJECTIVE:Analysis of twins with epilepsy to explore the genetic architecture of specific epilepsies, to evaluate the applicability of the 2010 International League Against Epilepsy (ILAE) organization of epilepsy syndromes, and to integrate molecular genetics with phenotypic analyses. METHODS:A total of 558 twin pair...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0000000000000790

    authors: Vadlamudi L,Milne RL,Lawrence K,Heron SE,Eckhaus J,Keay D,Connellan M,Torn-Broers Y,Howell RA,Mulley JC,Scheffer IE,Dibbens LM,Hopper JL,Berkovic SF

    更新日期:2014-09-16 00:00:00

  • Mineralization of the basal ganglia detected by CT in Hallervorden-Spatz syndrome.

    abstract::We studied a patient with autopsy-proven Hallervorden-Spatz syndrome (HSS) and the previously unreported finding of high-density lesions in the basal ganglia on CT. The diagnosis of HSS should be considered in a patient with dystonia and basal ganglia mineralization on CT. ...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.38.1.154

    authors: Tennison MB,Bouldin TW,Whaley RA

    更新日期:1988-01-01 00:00:00

  • Complications and limitations of drug therapy for Parkinson's disease.

    abstract::Levodopa is the most effective drug treatment for Parkinson's disease (PD). However, its chronic use is associated with dyskinesia, motor fluctuations, and hallucinations. There are various approaches to the management of levodopa complications. Motor fluctuations can be treated with a long-acting levodopa preparation...

    journal_title:Neurology

    pub_type: 杂志文章,评审

    doi:

    authors: Jankovic J

    更新日期:2000-01-01 00:00:00

  • Blood-brain barrier disruption is associated with increased mortality after endovascular therapy.

    abstract:OBJECTIVE:To evaluate the incidence, baseline characteristics, and clinical prognosis of blood-brain barrier (BBB) disruption after endovascular therapy in acute ischemic stroke patients. METHODS:A total of 220 patients treated with endovascular therapy between April 2007 and October 2011 were identified from a prospe...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0b013e31828406de

    authors: Desilles JP,Rouchaud A,Labreuche J,Meseguer E,Laissy JP,Serfaty JM,Lapergue B,Klein IF,Guidoux C,Cabrejo L,Sirimarco G,Lavallée PC,Schouman-Claeys E,Amarenco P,Mazighi M

    更新日期:2013-02-26 00:00:00

  • Lorazepam treatment of experimental status epilepticus in the rat: relevance to clinical practice.

    abstract::We studied the efficacy, pharmacokinetics, and brain entry of lorazepam in the treatment of status epilepticus (SE) using a rat model of secondarily generalized convulsive SE. Lorazepam entered the bloodstream rapidly following intraperitoneal injection. Brain concentrations peaked 10 minutes after peak serum levels w...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.40.6.990

    authors: Walton NY,Treiman DM

    更新日期:1990-06-01 00:00:00

  • Response of cluster headache to psilocybin and LSD.

    abstract::The authors interviewed 53 cluster headache patients who had used psilocybin or lysergic acid diethylamide (LSD) to treat their condition. Twenty-two of 26 psilocybin users reported that psilocybin aborted attacks; 25 of 48 psilocybin users and 7 of 8 LSD users reported cluster period termination; 18 of 19 psilocybin ...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/01.wnl.0000219761.05466.43

    authors: Sewell RA,Halpern JH,Pope HG Jr

    更新日期:2006-06-27 00:00:00

  • Combined azathioprine and prednisone in chronic inflammatory-demyelinating polyneuropathy.

    abstract::Twenty-seven patients with static or worsening chronic inflammatory-demyelinating polyradiculoneuropathy were randomly assigned to alternate day decremental prednisone therapy alone or with azathioprine (2 mg/kg) for 9 months. No statistically significant alterations were demonstrated between these treatment schedules...

    journal_title:Neurology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1212/wnl.35.8.1173

    authors: Dyck PJ,O'Brien P,Swanson C,Low P,Daube J

    更新日期:1985-08-01 00:00:00

  • Controlled study of the antiparkinsonian activity and tolerability of cabergoline.

    abstract::Cabergoline, a new ergoline derivative, is a D2-specific dopaminergic agonist that is more potent and longer-acting than other agonist agents. We conducted a randomized, double-blind study of increasing doses of cabergoline taken once a day. Twenty-five patients with Parkinson's disease taking stable doses of levodopa...

    journal_title:Neurology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1212/wnl.43.3_part_1.613

    authors: Hutton JT,Morris JL,Brewer MA

    更新日期:1993-03-01 00:00:00

  • Syndromes dominated by apraxia of speech show distinct characteristics from agrammatic PPA.

    abstract:OBJECTIVE:We assessed whether clinical and imaging features of subjects with apraxia of speech (AOS) more severe than aphasia (dominant AOS) are more similar to agrammatic primary progressive aphasia (agPPA) or to primary progressive AOS (PPAOS). METHODS:Sixty-seven subjects (PPAOS = 18, dominant AOS = 10, agPPA = 9, ...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0b013e31829c5ed5

    authors: Josephs KA,Duffy JR,Strand EA,Machulda MM,Senjem ML,Lowe VJ,Jack CR Jr,Whitwell JL

    更新日期:2013-07-23 00:00:00

  • Cerebrospinal fluid monoclonal gammopathy in multiple myeloma and Waldenström's macroglobulinemia.

    abstract::Serum ratios of monoclonal immunoglobulin (Ig) to total protein, monoclonal immunoglobulin to albumin, CSF/serum Ig-albumin index, and CSF to serum monoclonal immunoglobulin were obtained in 21 patients with multiple myeloma and 2 with Waldenström's macroglobulinemia. Twelve patients (3 with CNS complications) showed ...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.33.11.1411

    authors: Hansotia P,Gani K,Friedenberg W

    更新日期:1983-11-01 00:00:00