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A recent study led by researchers at Western University has uncovered promising results regarding the treatment of apathy in patients with Frontotemporal Dementia (FTD). The study suggests that frequent treatment with intranasal oxytocin—a hormone traditionally linked to empathy—could help alleviate one of the most debilitating symptoms of this neurodegenerative condition.
FTD, which primarily affects individuals between the ages of 40 and 65, impairs language, behavior, and decision-making, leading to a progressive decline in quality of life. Apathy, the lack of interest or motivation in everyday activities, is one of the most common early signs of the disease. Patients may lose interest in activities they once loved and become emotionally disengaged from loved ones, including family members and even pets.
For years, there have been no proven treatments to manage symptoms like apathy. However, this new research, funded by the Weston Family Foundation and the Canadian Institutes for Health Research, may be a step forward in addressing this unmet need. The study was published in Lancet Neurology and is recognized as the largest trial to date investigating treatments for FTD.
Notable Behavioral Improvements
“FTD often presents with changes in behavior—impulsivity, compulsive behaviors, and altered eating habits—and apathy is frequently one of the first symptoms to emerge,” said Dr. Elizabeth Finger, a professor at Schulich School of Medicine & Dentistry and a scientist at St. Joseph’s Health Care London’s Lawson Research Institute, who led the study. “The small, yet significant improvements we observed in some patients after oxytocin treatment offer hope for managing these challenging symptoms.”
A significant number of caregivers participating in the trial reported notable behavioral improvements in patients, including increased interaction with family members and more proactive behaviors, such as making coffee for a spouse. Kristy Coleman, the lead author of the study, emphasized how such seemingly small changes can have profound impacts on both the patients and their families.
“Even small gestures like calling a family member or showing interest in others’ well-being can make a huge difference in the lives of those caring for someone with FTD,” she said.
The phase 2a/b randomized, placebo-controlled clinical trial, conducted at 11 sites across Canada and the U.S. from 2018 to 2023, involved 74 patients. The treatment, which consisted of two daily doses of intranasal oxytocin over six weeks, demonstrated a measurable reduction in apathy, as assessed by caregivers using the Neuropsychiatric Inventory (NPI).
Field Needs More Study
Despite the promising results, experts urge caution. “The symptomatic treatment of FTD remains a field in need of much more research. There are currently very few evidence-based options for managing the diverse symptoms of FTD, including apathy,” said Coleman.
While the study’s results suggest a mild yet significant improvement in apathy, Dr. Finger noted that the effects were subtle but observable. “It’s not a dramatic change, but it is enough to make a noticeable difference, especially from the perspective of caregivers,” she said.
This breakthrough is the culmination of more than 15 years of research. Dr. Finger’s motivation to find a treatment for FTD patients stemmed from conversations with caregivers who voiced their frustrations over the lack of effective symptom management options.
A Step Forward for FTD Treatment
“This study represents an exciting step forward in our quest for specific treatments to address neuropsychiatric symptoms of FTD,” Dr. Finger said. “We hope this could pave the way for better options to support FTD patients and their families.”
While this research is groundbreaking, more studies are needed to further assess the long-term effects and broader applicability of oxytocin in managing FTD symptoms.
Reference:
“Intranasal oxytocin for apathy in people with frontotemporal dementia (FOXY): a multicentre, randomised, double-blind, placebo-controlled, adaptive, crossover, phase 2a/2b superiority trial” by Kristy K L Coleman, Scott Berry, Jeffrey Cummings, Ging-Yuek R Hsiung, Robert Laforce, Edward Huey, Simon Ducharme, Maria Carmela Tartaglia, Mario F Mendez, Chiadi Onyike, Kimiko Domoto-Reilly, Mario Masellis, Nathan Herrmann, Anton Porsteinsson, Michelle A Detry, Chloe Stewart, Anna L Bosse, Anna McGlothlin, Bryan Dias, Sachin Pandey, Michael Mayich, Stephen H Pasternak, Ramiro Ruiz Garcia, Miguel Restrepo-Martinez, Howard Feldman, Adam L Boxer, and Elizabeth C Finger. Lancet Neurology, 22 January 2025. DOI: 10.1016/S1474-4422(24)00456-3.
Disclaimer: This article is for informational purposes only and should not be considered medical advice. Always consult with a healthcare professional for medical concerns or treatments related to dementia or other health conditions.
