Effects of Donepezil on Central Processing Speed and Attentional Measures in Parkinson’s Disease with Dementia and Dementia with Lewy Bodies
We examined attention-enhancing effects of the cholinesterase inhibitor donepezil in Dementia with Lewy bodies (DLB) and Parkinson's disease with dementia (PDD) by means of open label study.
22 DLBs and 23 PDDs were assessed over 20 weeks using the Cognitive Drug Research Computerized Attentional Tasks. We examined how much closer our patients moved towards being normal for their age by comparing them to a non-demented elderly control sample (n = 183, aged 71-75 years).
Donepezil treatment improved power of attention, continuity of attention and reaction time variability. The deficit in responses was moved towards normal by 38 and 56% for power of attention and 22 and 10% for continuity of attention in PDD and DLB, respectively.
Improvements in attention were found with donepezil in PDD and DLB.
Available from: Erik Ch. Wolters
- "In AD, several cholinesterase inhibitors such as rivastigmine, galantamine and donepezil, were found to be (equally) effective in the treatment of mild to moderate AD (for review see (Birks, 2006)). In PDD, a number of open label studies and a randomized, placebo-controlled, multicenter study with rivastigmine have shown beneficial effects on cognitive function as well as on psychotic symptoms (Bullock and Cameron, 2002; Burn et al., 2006; Emre et al., 2004; Reading et al., 2001; Rowan et al., 2007; Wesnes et al., 2005). "
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ABSTRACT: EEG and MEG studies in Parkinson's disease (PD) related dementia (PDD) have shown a slowing of resting-state, oscillatory activity compared to non demented PD. Aim of the present MEG study was to determine whether treatment with the cholinesterase inhibitor rivastigmine would reverse this slowing of resting-state activity in PDD patients.
In eight PDD patients, whole head MEG was recorded in a resting-state condition before and after treatment with rivastigmine. Relative spectral power was calculated in the delta, theta, alpha, beta and gamma frequency bands in fronto-central, parieto-occipital and temporal regions.
After treatment with rivastigmine, PDD patients demonstrated an increase in relative power in the alpha range in parieto-occipital and temporal regions together with a diffuse increase in beta power. Furthermore, a decrease of delta power in fronto-central and parieto-occipital regions was found.
Treatment with the cholinesterase inhibitor rivastigmine at least partly counteracts the slowing of resting-state brain activity that is known to occur in PD related dementia.
Our observations emphasize the prominent role of degeneration of the cholinergic system in the pathophysiology of dementia in PD. In the future, MEG might contribute to the selection of PD patients who may optimally benefit from cholinergic treatment.
Available from: Ricardo F Allegri
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ABSTRACT: dementia and dementia with Lewy bodies are both frequent in the group of degenerative causes of cognitive impairment. Clinically, the diagnosis of these entities is characterized by a mixture of motor, neuropsychiatric and cognitive symptoms. In the last few years there have been several advances in the knowledge of the etiology, clinical characteristics, diagnosis and treatment of these diseases, which are updated in this article. Parkinsons disease dementia and dementia with Lewy bodies are considered as different points in the alpha synucleinopathies clinico-pathologic spectrum.
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