Disease-modifying properties of long-term lithium treatment for amnestic mild cognitive impairment: randomised controlled trial

Br J Psychiatry. 2011 May;198(5):351-6. doi: 10.1192/bjp.bp.110.080044.

Abstract

Background: Two recent clinical studies support the feasibility of trials to evaluate the disease-modifying properties of lithium in Alzheimer's disease, although no benefits were obtained from short-term treatment.

Aims: To evaluate the effect of long-term lithium treatment on cognitive and biological outcomes in people with amnestic mild cognitive impairment (aMCI).

Method: Forty-five participants with aMCI were randomised to receive lithium (0.25-0.5 mmol/l) (n = 24) or placebo (n = 21) in a 12-month, double-blind trial. Primary outcome measures were the modification of cognitive and functional test scores, and concentrations of cerebrospinal fluid (CSF) biomarkers (amyloid-beta peptide (Aβ(42)), total tau (T-tau), phosphorylated-tau) (P-tau).

Trial registration: NCT01055392.

Results: Lithium treatment was associated with a significant decrease in CSF concentrations of P-tau (P = 0.03) and better perform-ance on the cognitive subscale of the Alzheimer's Disease Assessment Scale and in attention tasks. Overall tolerability of lithium was good and the adherence rate was 91%.

Conclusions: The present data support the notion that lithium has disease-modifying properties with potential clinical implications in the prevention of Alzheimer's disease.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Alzheimer Disease / cerebrospinal fluid
  • Alzheimer Disease / physiopathology
  • Alzheimer Disease / prevention & control
  • Amyloid beta-Peptides / cerebrospinal fluid
  • Cognition Disorders / cerebrospinal fluid
  • Cognition Disorders / drug therapy*
  • Cognition Disorders / physiopathology
  • Disease Progression
  • Double-Blind Method
  • Glycogen Synthase Kinase 3 / drug effects*
  • Glycogen Synthase Kinase 3 / physiology
  • Glycogen Synthase Kinase 3 beta
  • Humans
  • Lithium Compounds / administration & dosage
  • Lithium Compounds / therapeutic use*
  • Middle Aged
  • Neuropsychological Tests
  • Spinal Puncture
  • Treatment Outcome
  • tau Proteins / cerebrospinal fluid*

Substances

  • Amyloid beta-Peptides
  • Lithium Compounds
  • tau Proteins
  • Glycogen Synthase Kinase 3 beta
  • Glycogen Synthase Kinase 3

Associated data

  • ClinicalTrials.gov/NCT01055392